Replacement of Ahmed Aqueous Drainage Devices in Eyes With Device-related Complications
Bibliographic record
Abstract
PURPOSE: To examine the results of removal and simultaneous replacement of Ahmed aqueous drainage devices (ADDs), which require removal due to complications. METHODS: Noncomparative retrospective case series of 6 patients. RESULTS: For the period from January 1999 to December 2007, 325 Ahmed ADD insertions were performed in 272 patients. From this, we identified 6 patients (1.8%) who underwent removal of an ADD for device-associated complications. All had replacement of the Ahmed ADD in a different quadrant at the same surgery. The mean time interval from the original valve insertion was 31.2 months (median, 32.5; range, 3 to 67 mo). The indication for tube removal was chronic uveitis in 3 patients, plate exposure in 2 patients, and tube exposure in 1 patient. We examined the results at 12 months postsimultaneous removal and replacement of the ADD and at final follow-up (median, 25 mo; range, 13 to 52 mo). The preoperative complications resolved in all cases, with the inflammation settling postoperatively in the patients with preoperative uveitis and no patients developing tube or plate exposure at last follow-up. The mean preoperative intraocular pressure (IOP) was 16.0 mm Hg (median, 15.0; range, 9 to 29 mm Hg). At 12 months and final review, the mean IOP was 10.8 mm Hg (median, 10.0; range, 1 to 24 mm Hg) and 11.0 mm Hg (median, 10.0; range, 3 to 24 mm Hg), respectively. The mean number of glaucoma medications preoperatively was 2.8 (median, 3.5; range, 0 to 5). This was reduced to 1.7 (median, 1.5; range, 0 to 4) at 12 months and 2.2 (median, 1.5; range, 0 to 5) at final follow-up. Of the 6 cases in this series, 4 (66.6%) were considered to have adequate IOP control postoperatively. One patient developed postoperative hypotony, with an IOP of 4 mm Hg and reduced vision due to hypotony maculopathy. This patient declined further surgical intervention. One patient had a preoperative IOP of 29 mm Hg on 4 drops and acetazolamide 250 mg b.i.d. At 14 months postsurgery, IOP was 24 mm Hg on 4 drops and the patient underwent insertion of a second ADD. At last follow-up 14 months later, IOP was 10 mm Hg on 4 drops. There were no other significant intraoperative or postoperative complications in this series. CONCLUSIONS: In patients who require removal of Ahmed ADDs due to complications, removal of the offending ADD and replacement in another quadrant is effective in both resolving the complications and maintaining IOP control.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".