Five-Year Pooled Data Analysis of the Ahmed Baerveldt Comparison Study and the Ahmed Versus Baerveldt Study

Christakis, Panos G.; Zhang, Dongyu; Budenz, Donald L.; Barton, Keith; Tsai, James C.; Ahmed, Iqbal Ike K.

doi:10.1016/j.ajo.2017.01.003

Cited by 170 publications

(166 citation statements)

References 31 publications

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“…The pooled data from the ABC and AVB studies12 at the end of 5 years also showed that BGD group produced a lower mean IOP (p=0.001) on fewer medications (p=0.007), had lower failure rates (p=0.007) and required lesser glaucoma reoperations ((p=0.006) than the AGV group. However, the BGD group carried a higher risk of hypotony (p=0.002), which was not seen in our study.…”

Section: Discussionmentioning

confidence: 86%

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Pathak-Ray

Rao

2018

Br J Ophthalmol

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Section: Discussionmentioning

confidence: 86%

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Pathak-Ray

Rao

2018

Br J Ophthalmol

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“…The IOP after BGI only decreased from 21.6 to 15 mmHg. Although this is a 31% decrease, lower IOP's were reached in large prospective trials such as the TVT (3 year IOP of 13.3 mmHg, a 47% decrease) [14], and the pooled Ahmed Baerveldt comparison (3 year IOP of 13.8 mmHg, a 57% decrease) [4].…”

Section: Discussionmentioning

confidence: 88%

“…The BGI is more effective than the valved Ahmed glaucoma implant (AGI) in achieving a lower failure rate and a lower IOP on fewer medications than AGIs at the expense of a higher risk of hypotony [4].…”

Section: Introductionmentioning

confidence: 99%

Longer-term Baerveldt to Trabectome glaucoma surgery comparison using propensity score matching

Kostanyan

Shazly

Kaplowitz

et al. 2017

Graefes Arch Clin Exp Ophthalmol

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1 AbstractPurpose: To apply propensity score matching to compare Baerveldt glaucoma drainage implants (BGI) to trabectome-mediated ab interno trabeculectomy (AIT). Recent data suggests that AIT can produce results similar to BGI which is traditionally reserved for more severe glaucoma.Methods: BGI and AIT patients with at least one year of follow-up were included. The primary outcome measures were intraocular pressure (IOP), number of glaucoma medications, and a Glaucoma Index (GI) score. GI reflected glaucoma severity based on visual field, the number of preoperative medications, and preoperative IOP. Score matching used a genetic algorithm consisting of age, gender, type of glaucoma, concurrent phacoemulsification, baseline number of medications, and baseline IOP. Patients with neovascular glaucoma, with prior glaucoma surgery or without a close match were excluded.Results: Of 353 patients, 30 AIT patients were matched to 29 BGI patients. Baseline characteristics including, IOP, the number of glaucoma medications, type of glaucoma , the degree of VF loss and GI were not significantly different between AIT and BGI. BGI had a preoperative IOP of 21.6±6.3 mmHg compared to 21.5±7.4 for AIT on 2.8±1.1 medications and 2.5±2.3, respectively. At 30 months, the mean IOP was 15.0±3.9 mmHg for AIT versus 15.0±5.7 mmHg for BGI (p>0.05), while the number of drops was 1.5±1.3 for AIT (change: p=0.001) versus 2.4±1.2 for BGI (change: p=0.17; AIT vs BGI: 0.007). Success, defined as IOP<21 mmHg, <20% reduction and no reoperation, was achieved at 1 year in 56% of AIT versus 55% of BGI (p>0.05) and 50% versus 52% at 2.5 years. Conclusions:A propensity score matched comparison of AIT and BGI demonstrated a similar IOP reduction through one year. AIT required fewer medications.2

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“…; Stead & King ; Christakis et al. ). Stead & King () found, in patients with very severe glaucoma (mean [SD] MD −25.3 [3.5] dB) who underwent a TE, that nine of 104 patients lost two lines of Snellen or more – deemed to be related to glaucoma – at the end of the follow‐up (i.e.…”

Section: Discussionmentioning

confidence: 99%

Influence of glaucoma surgery on visual function: a clinical cohort study and meta‐analysis

Montolio

Müskens

Jansonius

2018

Acta Ophthalmologica

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Purpose To determine the cost (loss of visual function associated with the procedure) and benefit (long‐term preservation of the visual field) of glaucoma surgery. Methods We included 100 patients who underwent glaucoma surgery (Baerveldt glaucoma implant [BGI], n = 61; trabeculectomy [TE], n = 39). Preoperatively, the median (interquartile range [IQR]) standard automated perimetry mean deviation (MD) was −12 (−16 to −6) dB. We analysed the change in visual acuity (BCVA) and MD due to the procedure and, in a subset with at least 5 years of perimetric follow‐up both pre‐ and postoperatively (n = 20), the change in rate of progression (ROP; time rate of change in MD). For the surgery‐induced change in ROP, we also performed a meta‐analysis including the current and previously published studies. From the surgery‐induced decrease in MD and change in ROP, we calculated the average postoperative duration needed for the benefit to surpass the cost. Results Mean (standard deviation) MD decline was 1.3 (2.7) and 1.0 (2.3) dB for BGI (p < 0.001) and TE (p = 0.009), respectively; no significant surgery‐induced changes in BCVA were found (p = 0.08 and p = 0.12, respectively). In our study, surgery was associated with a non‐significant deceleration of ROP (from −0.37 [0.52] to −0.15 [0.48] dB/year; p = 0.23). The meta‐analysis, based on eight studies, showed an overall surgery‐induced change in ROP of 0.44 (95% confidence interval 0.25 to 0.64; p < 0.0001) dB/year. Conclusion Glaucoma surgery significantly reduces the progression velocity in glaucoma. On average, the benefit of glaucoma surgery surpasses the cost after approximately 1.5 years.

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Five-Year Pooled Data Analysis of the Ahmed Baerveldt Comparison Study and the Ahmed Versus Baerveldt Study

Cited by 170 publications

References 31 publications

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Longer-term Baerveldt to Trabectome glaucoma surgery comparison using propensity score matching

Influence of glaucoma surgery on visual function: a clinical cohort study and meta‐analysis

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