April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
The Ahmed Versus Baerveldt (AVB) Study: 2 Year Results
Author Affiliations & Notes
  • Panos G. Christakis
    Yale School of Medicine, New Haven, Connecticut
  • David Zurakowski
    Anesthesiology, Children's Hospital Boston: Harvard Medical School, Boston, Massachusetts
  • James C. Tsai
    Ophthal & Vis Science, Yale Eye Center, New Haven, Connecticut
  • Jeffrey W. Kalenak
    Drs. Massaro & Kalenak, SC, Milwaukee, Wisconsin
  • Jeffrey A. Kammer
    Ophthalmology and Visual Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee
  • Louis B. Cantor
    Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana
  • Paul J. Harasymowycz
    Ophthalmology, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
  • Ike K. Ahmed
    Dpt of Ophthalmology & Vision Sciences, University of Toronto, Mississauga, Ontario, Canada
  • Footnotes
    Commercial Relationships  Panos G. Christakis, None; David Zurakowski, None; James C. Tsai, None; Jeffrey W. Kalenak, None; Jeffrey A. Kammer, None; Louis B. Cantor, AMO (C); Paul J. Harasymowycz, AMO (C, R); Ike K. Ahmed, AMO (C, R), NWM (R)
  • Footnotes
    Support  Glaucoma Research Society of Canada (GRSC 2005/2010)
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 2626. doi:
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      Panos G. Christakis, David Zurakowski, James C. Tsai, Jeffrey W. Kalenak, Jeffrey A. Kammer, Louis B. Cantor, Paul J. Harasymowycz, Ike K. Ahmed; The Ahmed Versus Baerveldt (AVB) Study: 2 Year Results. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2626.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To report 2-year results of the Ahmed versus Baerveldt (AVB) Study: a multicenter randomized clinical trial comparing the two most frequently implanted aqueous drainage devices.

Methods: : Patients were recruited from 7 international sites by 10 surgeons. Inclusion criteria required patients be 18+ years old with uncontrolled glaucoma refractory to medical, laser and surgical therapy. Eligible patients were randomized to receive either an Ahmed-FP7 valve (AGV) or a Baerveldt-350 implant (BGI) using standardized surgical technique. Outcome measures included intraocular pressure (IOP), visual acuity (VA), glaucoma medication use, complications and treatments. The IOP goal was 5mmHg-18mmHg inclusive with a reduction >=20% from baseline. Failure was defined as two consecutive visits from 3 months onwards in which the IOP goal was not met, additional glaucoma surgery, devastating complications, or loss of light perception.

Results: : 238 patients were enrolled, including 124 in the AGV group and 114 in the BGI group. There were no significant differences in baseline characteristics between the two groups. Prior to surgery, the study group had a mean IOP (±SD) of 31.4±10.8 mmHg on a mean of 3.1±1.0 glaucoma medications with a median Snellen VA of 20/100. At 2-years, mean IOP was 16.1±6.4 mmHg in the AGV group and 14.5±6.6 mmHg in the BGI group (p=0.12). Mean number of glaucoma medications required was 1.8±1.4 in the AGV group and 1.0±1.2 in the BGI group (p<0.001). Median Snellen VA was 20/150 in both groups (p=0.99). Complications occurred in 61(49%) AGV patients and 69(61%) BGI patients (p=0.08). Treatments were required in 40(32%) AGV patients and 54(47%) BGI patients (p=0.02). The cumulative probability of failure was 48% in the AGV group and 31% in the BGI group (p=0.02).

Conclusions: : At 2-years, the BGI group had a lower cumulative probability of failure and required a fewer mean number of glaucoma medications than the AGV group. However, more treatments were required in the BGI group. The two groups had comparable VAs, mean IOPs and experienced a similar number of complications.

Clinical Trial: : http://www.clinicaltrials.gov NCT00940823

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: outcomes/complications • anterior segment 
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