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M.L. Levine, B. Mason; Comparison of Ligated and Non–Ligated Ahmed Glaucoma Valve Implants With Incidence of Hypotony and Final Intraocular Pressures . Invest. Ophthalmol. Vis. Sci. 2006;47(13):33.
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To compare the rate of post–operative hypotony following Ahmed glaucoma valve (AGV) implantation either with or without suture ligation. Also to determine if the final IOP was different between the two groups as some reports have stated ligation of an AGV can cause valve membrane adhesion and dysfunction leading to an elevated IOP.
The medical records of all patients that underwent implantation of an AGV by one surgeon from January 2003 to February 2005 were reviewed. Visual acuity, intraocular pressure, and number of medications were collected pre– and post–operatively for each group of patients and compared statistically.
34 eyes received a ligated AGV while 12 received a non–ligated AGV. No statistically significant difference was found in pre–operative characteristics (type of glaucoma, vision, intraocular pressure, number of glaucoma medications). The non–ligated group had a significantly lower intraocular pressure on post–operative day 1 (5.3 vs 24.1 mmHg, p < 0.001). 8 out of 12 eyes (67%) in this group had an IOP of less than 5 mmHg at some point post–operatively compared to 2 out of 34 eyes (5.8%) in the ligated group. No statistically significant difference in final IOP was seen between the non–ligated and ligated group (12.8 vs 14.4 mmHg, p = 0.30). Also, no significant difference was found in post–operative vision (p = 0.35) or number of glaucoma medications (p = 0.48).
In this study AGV suture ligation helped prevent post–operative hypotony while maintaining function once the suture had dissolved without adverse effects on final IOP, number of medications, and visual acuity.
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