Intermediate outcomes of Ahmed glaucoma valve surgery in Asian patients with intractable glaucoma

Abstract

Objective To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implantation in Asian patients with refractory glaucoma. Methods The study was a retrospective interventional case series conducted at a single institution between January 2004 and January 2006. The study population included 91 patients (91 eyes). Results A total of 70 patients were successfully treated (74.5%). Postoperatively, the median intraocular pressures declined significantly to 13 mm Hg (interquartile range: 10-20 mm Hg) on day 1 (Po0.001) and 17 mm Hg (interquartile range: 12-19 mm Hg) at the last follow-up examination (Po0.001). The cumulative probability of success according to KaplanMeier life-table analysis was 74% at 12 months and 43% at 2 years. Hazard of failure increased slightly with age, HR: 1.03 (95% confidence interval (CI) ¼ 1.00-1.05; P ¼ 0.044). The most common complication was hyphaemia at 12.77%. There were no serious complications involving loss of visual acuity or sight. Conclusions AGV implantation is an acceptable treatment for refractory glaucoma in high-risk patients with few additional options.

Factors associated with the surgical outcomes of Baerveldt glaucoma implant for open-angle glaucoma, an age-related eye disease

“…Generalizing the results from these reports to the surgical outcomes of BGI for OAG may be difficult because the surgical outcomes of GDD for refractory glaucoma are quite different from those of BGI for OAG. Among these seven reports, two studies reported opposite results to those in this study; Seah et al 13 and Tai et al 17 have reported that older age was associated with the surgical failure of GDD. In addition to the difference in glaucoma type (OAG and refractory glaucoma), the difference in the age range of patients between the two studies and this study may have caused the difference in the results.…”

Early Ahmed Glaucoma Valve Implantation after Penetrating Keratoplasty Leads to Better Outcomes in an Asian Population with Preexisting Glaucoma

“…Our study differs from other studies that have been mentioned in that the majority of patients who were included in it had chronic angle-closure glaucoma. In general, AGV implantation has been thought to be relatively effective with respect to controlling glaucoma in different types of patients [21], [22], and neither glaucoma nor corneal diagnosis has been shown to influence the success of long-term glaucoma control with GDDs. However, our experience has shown the success rate of AGV implantation may be influenced by the type of glaucoma; for example, we have found evidence of poor outcomes of AGV implantation in controlling neovascular glaucoma [22].…”

“…In general, AGV implantation has been thought to be relatively effective with respect to controlling glaucoma in different types of patients [21], [22], and neither glaucoma nor corneal diagnosis has been shown to influence the success of long-term glaucoma control with GDDs. However, our experience has shown the success rate of AGV implantation may be influenced by the type of glaucoma; for example, we have found evidence of poor outcomes of AGV implantation in controlling neovascular glaucoma [22]. Furthermore, our Cox regression analysis also showed that the patients with preexisting angle-closure glaucoma had an increased risk of AGV failure compared with other patients.…”

Clinical Outcomes of FP-7/8 Ahmed Glaucoma Valves in the Management of Refractory Glaucoma in the Mainland Chinese Population

“…Due to the differences in the enrolled populations, follow-up periods, and success criteria, it is difficult to compare success rates across studies. According to previous reports, the complete success rate of AGV implantation has ranged from 25.2% to 94% [ 16 , 17 , 18 ]. Our complete success rate was in accordance with that of the most recent randomized controlled trial by Panos G. Christakis and associates, which compared the AGV with the Baerveldt (AVB) [ 13 ].…”