Fernando Fernandes’s scientific contributions

Purpose: To determine the morphometric parameters of filtration blebs of a valved aqueous humor drainage device. Materials and methods: Orbital magnetic resonances imaging (MRI) was taken after implantation of an Ahmed valve (FP7 model). Outcomes of the analysis were intraocular pressure (IOP) and the bleb’s morphometric analysis (volume, height, major and minor axis). Associations between IOP and the imaging-related study variables were explored by Spearman’s correlation test. Results: Eleven patients underwent orbital MRI examination. Recordings were taken after a mean of 2.7 months (1-6 months) after surgery. IOP was significantly lower than its preoperative values (17.6 ± 6.4 mm Hg vs 36.1 ± 6.4 mm Hg, p < 0.01). Mean bleb volume was 856.9 ± 261 mm³ and its height, major and minor axis were 5.77 ± 1.9, 14.8 ± 2.9 and 8.14 ± 3.6 mm, respectively. A positive correlation was detected between IOP and mean height (r = 0.77, p = 0.048) and major axis (r = 0.83, p = 0.03). Interestingly, the overall bleb volume was related to IOP levels immediately prior to surgery (r = 0.75, p < 0.01). Additionally, the posterior part of the plate was found to be displaced from the scleral surface in five cases (45%). Conclusion: Ahmed valve’s bleb morphology seems to correlate with both the pre- and postoperative IOP, which might suggest a clinical benefit of administering aqueous suppressants pre- as well as postoperatively. The plate of the device may show a significant dislocation from its initial surgical implantation site. How to cite this article: Ferreira J, Fernandes F, Patricio M, Brás A, Rios C, Stalmans I, Pinto LA. Magnetic Resonance Imaging Study on Blebs Morphology of Ahmed Valves. J Curr Glaucoma Pract 2015;9(1):1-5.

Purpose: To evaluate the clinical outcomes of patients with suprachoroidal drainage devices. Methods: The authors describe 4 cases of patients presenting with preoperative intraocular pressures (IOP) between 30-40 mmHg, under triple glaucoma medication and history of multiple intraocular surgeries, who underwent suprachoroidal drainage device (StarFlo®) implantation. The following parameters were evaluated: preoperative and postoperative IOP (1 day, 1 week and 1, 3 and 6 months), the use IOP-lowering medication and operative and post-operative complications. IOP reduction in over 30% or <21mmHg was considered relative or absolute success depending on whether this was achieved with or without use of further surgical intervention or medical IOP-lowering treatment, respectively. Results: At 3 months, there was a reduction in IOP greater than 30% to 3 months post-operative (Baseline IOP: 34 ± 2 mmHg, 3 months IOP: 13 ± 3 mmHg). After this period, IOP-lowering medication was re-started in 2 patients in order to sustain the higher than 30% IOP-lowering reduction. One of the patients with relative success criteria was lost in follow at 3 months. In our last observation, IOP remains lower than preoperative IOP (6 months IOP 13 ± 4 mmHg). No there were no complications during the procedure. A patient presented with hyphema in the first postoperative day, which spontaneously resolved. Conclusions: Suprachoroidal drainage devices seem to reduce IOP significantly, are technically feasible and have few postoperative complications.