Abstract
Purpose: :
To evaluate the long-term outcomes of Ahmed glaucoma valve placement (AGV) in patients with uveitic glaucoma (UG) versus primary open angle glaucoma (POAG).
Methods: :
In a retrospective comparative case-control study, data was collected for 23 eyes (23 patients) with UG and 23 eyes (23 patients) with uncontrolled POAG who underwent primary Ahmed glaucoma valve placement. Patients with UG were older than 25 years of age and had no previous glaucoma surgical procedure. A control group of POAG was matched based on age and mean deviation of the preoperative visual field. Postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, and complications were compared at the preoperative day, one day after surgery, 3, 6, 12, 24, 36, 48, and 60 months.
Results: :
A total of 46 eyes (23 in each group) were included with a mean follow-up of 43.57 ± 22.9 months. There were no differences in age (60.82 years ±17.5 and 60.91 ± 16.5 p = 0.855) or mean deviation at the preoperative visual field (-13.08 ± 7.58 and -13.3 ± 8.5 p =0.091). There were no differences between groups in preoperative IOP or number of medicines used for glaucoma. Preoperative IOP was 27.36 ± 10 mmHg for UG and 26.09 ± 13.41 mmHg for POAG (p= 0.359). After surgery IOP decreased significantly in both groups; from 27.36 mmHg before surgery to 17.47 three months after surgery in UG (p<0.001) and 26.69 mmHg before to 14.81 mmHg 3 months after surgery in POAG (p<0.001). No significant differences in IOP or number of medicines used were found at 3, 6, 12, 24, 36, 48 or 60 months between the two groups. At 12 months IOP was 13.41 mmHg ± 3.66 for UG and 17.3mmHg ± 7.14 for POAG (p=0.143) and at 60 months 13.02 mmHg ± 2.87 and 13.25 mmHg 3.96 ± respectively (p=0.53). We had a power of 80% to detect a mean difference of 4 mmHg between groups.
Conclusions: :
No statistical difference in IOP reduction, number of medications or complications was found between UG and POAG in the early postoperative period or at long-term follow-up.
Keywords: uveitis-clinical/animal model