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C.C. Johnson, J. Kammer, M. Dietrich, J.C. Tsai; The Baerveldt Shunt vs. the Ahmed Shunt: Longer Term Outcomes of a Single Surgeon . Invest. Ophthalmol. Vis. Sci. 2005;46(13):82.
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Purpose: To determine longer term surgical outcomes of the Baerveldt and Ahmed implants in the treatment of refractory glaucoma. Methods: A retrospective chart review was conducted of 118 consecutive patients who underwent glaucoma shunt inplantation (70 Baerveldt, 48 Ahmed) by a single surgeon (JCT) from 1996–2000. The intraocular pressure (IOP) profile, medical regimen, and surgical complications were recorded for each patient at post operative day 1, 1 week, 1 month, 3 months, 6 months and every 6 months thereafter up to 48 months. The main outcome measure was surgical success (5<IOP<22) without additional glaucoma surgery or devastating complications. Other outcome measures included mean IOPs, number of medications required, and median time to failure. Results: There was no statistically significant difference in success rates at 1, 2, 3, or 4 years, with 4–year success rates of 62% for the Ahmed and 64% for the Baerveldt (P=0.843). However, the median time to failure for the Ahmed was 15.0 months, compared to 3.2 months for the Baerveldt (P=0.009). Additionally, patients who underwent Ahmed implants required significantly more medications at the 18, 24, 30, and 36–month time points (for all, p<0.05). Complications resulting from low IOPs were more likely seen in the Baerveldt group, while surgical failure due to uncontrolled IOPs tended to occur in the Ahmed patients. Conclusions: The Ahmed and Baerveldt shunt device have comparable success rates up to 4 years following implantation. Reasons for surgical failure may differ among the two surgical groups. In addition, the Baerveldt group required fewer glaucoma medications for IOP control starting at 18 months after surgery.
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