Purchase this article with an account.
M.O. Brasil, E.J. Rockwood, S.D. Smith; Comparison Of Silicone Ahmed And Baerveldt Glaucoma Implants In Refractory Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):27.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare the safety and efficacy of silicone Ahmed Glaucoma Implant (S–AGI) and Baerveldt Glaucoma Implant (BGI) in the treatment of patients with refractory glaucoma.
A retrospective chart review of 188 eyes of 180 consecutive patients who underwent either BGI (250, 325 or 425 mm2) or S–AGI (model FP–7) implantation with a minimum follow–up period of 6 months was performed. Patients who underwent previous cyclodestruction were excluded. The primary outcome measures were IOP, complication rate and surgical success. Surgical success was defined as IOP reduction of at least 20% from baseline and final IOP > 5 mmHg and < 22 mmHg. Eyes requiring additional glaucoma surgery, implant removal or who lost light perception were considered surgical failures.
117 eyes received BGIs and 71 eyes received S–AGIs. A greater proportion of patients in the S–AGI group had uveitic glaucoma (25.3% vs 10.3%, p=0.001). A corresponding greater proportion of patients in the BGI group had primary open angle glaucoma (48.2% vs 19.7%, p=0.001). Although the baseline IOP was similar in the two groups, the number of glaucoma medications was greater in the S–AGI group (p=0.001). The mean postoperative IOP was lower in the BGI group at 6 months (15.3 vs 18.1 mmHg) and 1 year (12.9 vs 16.1 mmHg) follow–up (both p<0.01). No significant difference in the success rate was seen between the S–AGI and BGI groups at 6 months (71.8% vs 76.1%, p=0.6) and 1year (67.6% vs 68.4%, p=1.0). The number of postoperative glaucoma medications also did not differ between the two groups. Persistent hypotony (IOP ≥ 5 mmHg) was found only in the BGI group, with 5.1% and 7.7% having hypotony at 6 months and 1 year, respectively. This difference was statistically significant at the 1 year time point (p=0.01). Although the difference did not reach statistical significance, choroidal hemorrhage was seen only in the BGI group with 4.3% experiencing this complication (p=0.16).
Both BGI and S–AGI are equally effective in controlling IOP. However, the BGI is associated with a greater likelihood of developing ocular hypotony, and may also be more likely to result in choroidal hemorrhage.
This PDF is available to Subscribers Only