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Iris Moroz, Shlomo Melamed, Oded Sagiv, Guy Ben Simon, Modi Goldenfeld, Alon Skaat; Ahmed Glaucoma Valve versus Gold Micro Shunt (GMS) implants - Five years Results of a Prospective Randomized Clinical Trial. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4745.
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To report 5-year outcomes of Ahmed Glaucoma Valve (AGV) implantation Compared with the Gold Micro Shunt (GMS) implants (20µ GMS and 40µ GMS-Plus) in the treatment of refractory glaucoma.
Comparative prospective interventional clinical trial. A total of 32 eyes of 32 patients with refractory glaucoma were prospectively assigned to either AGV or GMS implantation. All procedures were performed by a single surgeon at the Glaucoma Service of Goldschleger Eye Institute between January 2006 and July 2007. Kaplan-Meier survival with success defined as intraocular pressure (IOP) > 5 mmHg and < 22 mmHg and at least 20% reduction from preoperative IOP (with or without antiglaucoma medications). Secondary outcome measures included intraocular pressure, visual acuity, number of glaucoma medications and comparison between 20µ GMS and 40µ GMS-Plus subgroups.
At the end of the follow up period, the AGV group had a significantly reduced final mean IOP of 17.3 ± 1.7 mmHg (vs. pre IOP of 33.5± 4.1 mmHg, P = 0.004) - a reduction of a mean 16.1± 4.0 mmHg, without a significant change in the final mean number of 2 ± 0.5 medications (vs. 2.5±0.4 pre-op, P = 0.43). The GMS group had a significantly reduced final mean IOP of 20.2 ± 1.8 mmHg (vs. pre IOP of 31.1± 1.2 mmHg, P = 0.0001) - a reduction of a mean 10.9± 2.2 mmHg, without a significant change in the final mean number of 2.6 ± 1.5 medications (vs. 3.0±0.2 pre-op, P = 0.24). The cumulative successes for the AGV group was 0.78 and for the GMS group was 0.67 with a similar rate of success based on the Kaplan-Meier survival functions (P = 0.83).
No difference was shown in the success rate between the AGV and GMS during 5 years of prospective follow-up. Both procedures were associated with similar IOP reduction and use of supplemental medical therapy at 5 years.
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