Purchase this article with an account.
F.E. Lima, L. Magacho, N. Guimaraes, M. Avila, R. Susanna; A Prospective, Randomized, Comparative Study between Endoscopic Cyclophotocoagulation and the Ahmed Drainage Implant in Refractory Glaucoma . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4294.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare endoscopic cyclophotocoagulation (ECP) and Ahmed drainage implant in the treatment of refractory glaucoma. Methods: Sixty-eight eyes with refractory glaucoma were randomized prospectively to either ECP or Ahmed tube shunt implantation. All procedures were performed by a single surgeon. Eyes that were included were pseudophakic with a history of at least one trabeculectomy with an antimetabolite, an intraocular pressure (IOP) equal to or above 35 mmHg on maximum tolerated medical therapy, and a visual acuity better than light perception. Exclusion criteria included eyes that had had previous glaucoma drainage device implantation or a cyclodestructive procedure. Success was defined as an IOP more than 6 mmHg and less than 21 mmHg, with or without topical anti-hypertensive therapy. Results: The mean follow-up was 19.82 ± 8.35 months and 21.29 ± 6.42 months, for the Ahmed and ECP groups, respectively (p = 0.4). The pre-operative IOP, 41.32 ± 3.03 mmHg (Ahmed) and 41.61 ± 3.42 mmHg (ECP) (p = 0.5), and the mean post-operative IOP, at 24 months follow-up, 14.73 ± 6.44 mmHg (Ahmed) and 14.07 ± 7.21 mmHg (ECP) (p = 0.7), were significantly different from baseline in both groups (p<0.001). Kaplan-Meier survival curve analysis showed a probability of success at 24 months of 79.17% and 82.53% for the Ahmed and ECP groups respectively (p = 0.7). Complications included choroidal detachment (Ahmed 17.64%, ECP 2.94%), shallow anterior chamber (Ahmed 17.64%, ECP 0.0%) and hyphema (Ahmed 14.7%, ECP 17.64%). Conclusions: There was no difference in success rate between the Ahmed Glaucoma Valve and ECP in refractory glaucoma. The eyes that underwent Ahmed tube shunt implantation had more complications than those treated with ECP.
This PDF is available to Subscribers Only