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Jesus Jimenez-Roman, Felix Gil-Carrasco, Vital P. Costa, Rul Barroso-Schimiti, Fabián Lerner, Priscila Rezende Santana, Jose Paulo Cabral Vascocellos, Karina Fabre-Miranda; Intraocular Pressure Control after Implantation of a Second Ahmed Glaucoma Device. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3721.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the results of a second Ahmed drainage device in eyes with refractory glaucoma that had undergone prior Ahmed device implantation.
This multicenter, retrospective study evaluated 58 eyes (58 patients) that underwent a second Ahmed drainage device (model S2- n=50, model FP7-n=8) due to uncontrolled IOP under maximal medical therapy. Outcome measures included IOP, visual acuity, number of antiglaucoma medications, and complications. Success was defined as IOP < 21mmHg (criterion 1) or 30% reduction of IOP (criterion 2) with or without antiglaucoma medications. Persistent hypotony (IOP < 5 mmHg after 3 months of follow-up), loss of light perception, and reintervention for IOP control were defined as failure
Mean preoperative IOP and the mean IOP at 6 months, 12 months, 24 months, and 30 months were 27.61 + 1.31 mmHg (n=58), 15.08 + 0.88 mmHg (n=51), 14.42 + 0.81 mmHg (n=43), 13.52 + 0.63 mmHg (n=21), and 14.81+ 0.87 mmHg (n=16), respectively. Mean IOP reductions were statistically significant at all time intervals (p<0.001). Mean number of antiglaucoma medications preoperatively, at 6 months , 12 months, 24 months, and 30 months were 3.16 + 0.16 (n=58), 1.55 + 0.16 (n=51), 1.36 + 0.18 (n=43), 0.66 + 0.14 (n=21), and 0.57+ 0.15 (n=16), respectively. The reductions in mean number of antiglaucoma medications were statistically significant at all time intervals (p<0.001). According to criterion 1, Kaplan-Meier survival curves disclosed success rates of 70% at 12 months and 62% at 30 months. According to criterion 2, Kaplan-Meier survival curves disclosed success rates of 46% at 12 months and 38% at 30 months. The most frequent complications were hypertensive phase (10.3%), choroidal detachment (6.9%), and corneal edema (15.5%).
Conclusions: Second Ahmed glaucoma device insertion may effectively reduce IOP in eyes with uncontrolled glaucoma, and is associated with relatively few complications.
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