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DL Miele, L Herndon, P Lee, S Stinnett, S Asrani, RR Allingham, PC Challa; Early Clinical Experience with the Ahmed Glaucoma Bi-Plate . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1065.
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Purpose: Pilot study to evaluate the AhmedTM Glaucoma Bi-Plate (B-1) implanted for pressure control in glaucoma patients. Methods: Retrospective case series reviewing intraocular pressures, visual acuity, number of glaucoma medications, and any ocular complications related to the implant. Statistical analysis was performed using the Wilcoxon signed rank test. Results: Twelve patients underwent implantation of the B-1 implant with eleven followed for six months. Diagnoses were six POAG, three NVG, one congenital, one uveitis-associated, and one cornea-associated glaucoma. Mean pre-operative IOP was 30.7 (SD=6.3) and last recorded post-operative IOP was 16.4 (SD=5.6). The mean IOP reduction from baseline at six months was -43.9 percent (SD=23.5, p=0.004). 27.3% of patients had final IOP </= 12, 27.3% had IOP 13-15, 9.1% had IOP 16-18 and 36.6% had IOP 19-24. The mean number of pre-operative glaucoma medications was 3.4 (SD=0.9) decreasing to 1.5 post-operatively (SD=1.0, p=0.001). Four individuals developed post-operative complications. One developed accessory plate extrusion, which was removed without further tube compromise and another developed post-operative choroidals, which resolved within five weeks. One individual developed malignant glaucoma, successfully treated by YAG laser hyaloidotomy and another individual developed vitreous occlusion of the tube requiring anterior vitrectomy. Conclusions: The Ahmed Glaucoma Bi-Plate effectively lowers IOP and reduces the number of glaucoma medications required for glaucoma management. In this small pilot study, the major post-operative complications include accessory plate extrusion, choroidal formation and malignant glaucoma. This compares somewhat favorably to the published six-month IOP lowering data with the single plate Ahmed.
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