LONG-TERM RESULTS OF KRUPIN-DENVER VALVE IMPLANTS IN FILTERING SURGERY FOR NEOVASCULAR GLAUCOMA

The long-term results obtained with the Krupin eye short valve shunt i n 28 eyes with neovascular glaucoma were retrospectively analyzed by m eans of Kaplan-Meier survival curve. The preoperative intraocular pres sures (IOPs) ranged from 28 to 62 mm Hg (mean, 36.8+/-5.8 mm Hg). Succ ess was considered an IOP of less than 22 mm Hg and greater than 5 mm Hg without medication (complete success) or with medication (qualified success) without additional glaucoma filtering surgery or devastating complications. Postoperative success was obtained in 10 out of 28 eye s after a mean follow-up period of 58.4+/-23.02 months (range, 10-108 months). The 3- and 6-year life table success rates were 66 and 34%, r espectively. Early complications were: shallow or flat anterior chambe r (15 patients, 53.6%), hypotony (16 patients, 57.1%), hypertony (7 pa tients, 25%), serous choroidal effusion (7 patients, 25%), fibrinous u veitis (5 patients, 17.9%), blockage of the intracameral portion of th e tube by fibrin (5 patients, 17.9%), choroidal hemorrhage (2 patients , 7.1%). Late complications were: external conjunctival bleb failure ( 12 patients, 42.9%), blockage of the intracameral portion of the tube by fibrovascular tissue (5 patients, 17.9%), cataract (2 patients, 7.1 %), bullous keratopathy (2 patients, 7.1%), external erosion of the Si lastic valve (2 patients, 7.1%), phthisis bulbi (2 patients, 7.1%). Mo rtality during long-term follow-up was high in our series. The complic ations of an underlying diabetes mellitus were the most common causes of death (15 out of 22 patients). The high mortality of patients subje cted to valve implantation makes it difficult to interpret the results of long-term studies. However, the valve implant is still today an al ternative surgical procedure for controlling IOP in eyes with neovascu lar glaucoma that have visual potential.