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S. M. Walsman, L. A. Al-Aswad; Visual Outcomes in Treating Neovascular Glaucoma With Ahmed Valves. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4418.
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To compare visual acuity, intraocular pressure (IOP), and rate of hypotony in cases of neovascular glaucoma (NVG) treated with Ahmed Glaucoma Valve implant (AGV) versus those treated without filtration surgery with or without diode laser cyclophotocoagulation (DCPC).
Retrospective comparative case series. Reviewed 65 eyes of 63 patients with underlying diagnosis of NVG, divided into two groups: Ahmed valve (N=28) and medically treated prior to 1993 (N=37). All cases done at single institution and cross-matched by age, race, and gender. The primary outcome measure was best-corrected visual acuity. Secondary outcome measure was the intraocular pressure. Third outcome was rate of hypotony.
The average follow-up was 12.1±1.1 months for the AGV group and 10.8±2.5 months for the medically treated group (p=0.574). No statistically significant difference between the groups was observed in terms of the etiology of NVG. Preoperative mean IOP and visual acuity were similar in both groups. The average visual acuity outcome in the AGV group was 20/200 while the medically treated group was count fingers (CF). The average IOP of the AGV group was 17.0±1mmHg, the medically treated group was 19.0±1mmHg. The rates of hypotony were 2.0% versus 17.1% (p=0.001).
Both AGV and medical therapy with or without DCPC can control IOP in cases of neovascular glaucoma. Overall visual acuity outcomes appear better with AGV and the rate of hypotony is statistically reduced.
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