Abstract
Purpose: :
To investigate the one year efficiacy of intraocular pressure (IOP) reduction and complications of Ahmed valve (AGV) implantation in refractory glaucoma.
Methods: :
Data of 42 patients with refractory glaucoma (42 eyes) regarding age, gender, eye laterality, specific glaucoma diagnosis, best-corrected visual acuity (BCVA), number of medications, IOP, surgical complications, and follow-up interval were collected from all visits and were analyzed. The primary outcome measure was cumulative probability of success defined as IOP of less than 21 mm Hg and of 5 mm Hg or more with a minimum of 15% reduction from baseline IOP, without additional glaucoma surgery or loss of light perception.Secondary outcomes included IOP and number of medications at three, six and 12 months after surgery, surgical complications, and final BCVA.
Results: :
The cumulative probability of success was 83. 3% after one year. IOP was reduced from a mean of 37. 45 mmHg (+/- 10. 3) at baseline to 13. 4 (+/-7.8) mmHg at month 1 (P < .001) to 15. 6 (+/-8.9) mmHg at month 3 (P < .001) to 12.9 (+/- 5.7) mmHg at month 6 (P < .001) to 10.9 (+/- 5.1) mmHg at month 12 (P < .001). The number of medications decreased from 3.3 medications at baseline to 0. 33 +/- 0. 75 at month 1 to 0. 63 +/- 0.83 at month 3 to 0. 61 +/- 0.88 at month 6 to 0. 53 +/- 0.80 at month 12 (P < .0001). Age was no statistically significant risk factor for failure. Prior glaucoma surgery was a statistically significant risk factor for failure (P < .05). Visual acuity remained stable in 57 %, became worse in 28. 5% and improved in 14. 3 %.
Conclusions: :
Consistent with findings of other studies, approximately 83 % of AGV implantations in refractory glaucoma were considered successful after one year of follow-up. Prior glaucoma surgery was a statistically significant risk factor for failure.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications