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Olga Furashova, Karin Pillunat, Eberhard Spoerl, Lutz Pillunat; Long-term results after Ahmed glaucoma valve implantation for different types of glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4783.
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To present long-term outcomes of Ahmed glaucoma valve implantation in patients with different types of glaucoma.
Retrospective chart review of 214 patients (214 eyes) with different types of glaucoma, who underwent Ahmed valve implantation (model FP7, New World Medical, Rancho Cucamonga, CA). Surgical success was defined as an IOP reduction of more than 20% and additionally between 5 and 21 mmHg at 1,2,3 and 4 years after surgery.
Among the 214 eyes were 32.2% suffering from neovascular glaucoma (NVG), 28.5% suffering from primary open angle glaucoma (POAG), 10.7% suffering from congenital glaucoma, 7.9% suffering from uveitic glaucoma, 3.7% suffering from pseudoexfoliative glaucoma, 1.9% suffering from angle closure glaucoma and 23% suffering from other secondary types of glaucoma. Mean IOP preoperative was 38.6+-11.2 mmHg. After 1 year follow-up, the success rate was 92.3% (167 of 181 eyes) with mean IOP 14.7+-5.0 mmHg (p<0.001; t-test for paired samples); by 2 years, the success rate was 93.6% (147 of 157 eyes) with mean IOP 14.3+-4.7 mmHg (p<0.001; t-test for paired samples). At 3 and 4 years after implantation success rates were 95.2% (119 of 125 eyes) with mean IOP 14.0+-4.7 mmHg (p<0.001; t-test for paired samples) and 92.3% (84 of 91) with mean IOP 14.0+-4.6 mmHg (p<0.001; t-test for paired samples) respectively. At four years, the success rate in the POAG group was significantly higher than that in the NVG group (96% vs. 75%, p=0.04 by Chi2-test). Preoperative history of cyclocryocoagulation/cyclophotocoagulation was not a significant risk factor for surgical failure of Ahmed valve implantation (97% success rate in the group with previous cyclocryocoagulation/cyclophotocoagulation vs. 93% in the group without these; p=0.410 by Chi2-test).
Ahmed glaucoma valve implantation is a safe and successful procedure for decompensated glaucoma. Long - term success rates are depending on the type of glaucoma. A history of cyclocryocoagulation or cyclophotocoagulation seems not to be a risk factor for failure after Ahmed valve implantation.
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