Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Variation of Ahmed Glaucoma Valve Priming Stream Patterns and Predictive Value on Valve Functionality
Author Affiliations & Notes
  • Iden Amiri
    Ophthalmology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Heran Gebreyesus
    Ophthalmology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Jennifer Patnaik
    Ophthalmology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Malik Kahook
    Ophthalmology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Leonard Seibold
    Ophthalmology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
  • Footnotes
    Commercial Relationships   Iden Amiri None; Heran Gebreyesus None; Jennifer Patnaik Orbis, GoCheck Kids, Code C (Consultant/Contractor); Malik Kahook New World Medical, SpyGlass Pharma, Code C (Consultant/Contractor), SpyGlass Pharma, Code O (Owner), New World Medical, Alcon, SpyGlass Pharma, Code P (Patent); Leonard Seibold New World Medical, Code C (Consultant/Contractor)
  • Footnotes
    Support  Unrestricted Research grant to the Department of Ophthalmology from RPB and an investigator initiated study grant from New World Medical
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 3525. doi:
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      Iden Amiri, Heran Gebreyesus, Jennifer Patnaik, Malik Kahook, Leonard Seibold; Variation of Ahmed Glaucoma Valve Priming Stream Patterns and Predictive Value on Valve Functionality. Invest. Ophthalmol. Vis. Sci. 2024;65(7):3525.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There is a lack of information regarding the efficacy and function of Ahmed Glaucoma Valves (AGV) that do not exhibit a distinct fluid stream priming pattern. The purpose of this study is to determine if there is a significant difference in valve function by comparing the steady state pressure across valves with or without a stream priming pattern.

Methods : In this experimental study, 50 AGVs were primed in standard fashion under microscope visualization by injecting balanced salt solution through a 27-gauge cannula and the priming pattern was recorded. Of these, a total of 15 AGVs were further tested using similar numbers of AGVs with or without a distinct stream priming pattern. A perfusion system consisting of a syringe pump, pressure transducer, water bath and test sample connected in sequence via tubing was used to determine the steady state pressure across the valves. All AGV’s achieved steady state pressure by 60 seconds of perfusion. A student t-test was used to assess statistically significant differences in the mean steady state pressures between the two groups of AGV’s.

Results : Of the 50 AGVs tested, 43 (86%) demonstrated a distinct jet/stream priming pattern, with only 7 (14%) having a pooling pattern without a distinct fluid stream. The perfusion study included 15 AGV’s; 8 with and 7 without a distinct stream priming pattern. Steady state pressure was reached by 45 seconds for all samples. The steady state pressure across the AGVs was similar between the two priming groups at all times tested. The mean steady state pressure (± standard deviation) in the stream group at 60 seconds was 11.00 ± 1.90 mmHg and 10.31 ± 2.53 mmHg in the group without a distinct stream pattern (p=0.56).

Conclusions : The predominant fluid pattern noted during priming of the Ahmed Glaucoma Valve is a distinct stream exiting the valve, with approximately 1 in 7 not demonstrating this pattern. However, we found that the fluid pattern visualized during priming has no predictive value on the functionality of the valve with similar steady state pressures achieved regardless of priming pattern.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1. Pressure across valve by sample and pattern type over the first 60 seconds.

Figure 1. Pressure across valve by sample and pattern type over the first 60 seconds.

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