Short term outcome of Ahmed glaucoma valve implantation in management of refractory glaucoma in a tertiary hospital in Oman

Abstract

Background:We present outcomes of Ahmed Glaucoma Valve (AGV) implantation in treating refractory glaucoma in a tertiary hospital in Oman. Refractory glaucoma was defined as previously failed conventional glaucoma surgery and an uncontrolled intraocular pressure (IOP) of more than 21 mm Hg despite treatment with three topical and/or oral therapy.Materials and Methods:This historical cohort study was conducted in 2010. Details of medical and surgical treatment were recorded. Ophthalmologists examined eyes and performed glaucoma surgeries using AGV. The best corrected distant vision, IOP, and glaucoma medications were prospectively reviewed on 1st day, 1st, 6th, 12th week postoperatively, and at the last follow up.Result:Glaucoma specialists examined and treated 40 eyes with refractory glaucoma of 39 patients (20 males + 19 females). Neo-vascular glaucoma was present in 23 eyes. Vision before surgery was <3/60 in 21 eyes. At 12 weeks, one eye had vision better than 6/12, seven eyes had vision 6/18 to 6/60, and eight eyes had vision 6/60 to 3/60. Mean IOP was reduced from 42.9 (SD 16) to 14.2 (SD 8) and 19.1 (SD 7.8) mmHg at one and 12 weeks after surgery, respectively. At 12 weeks, five (12.5%) eyes had IOP controlled without medication. In 33 (77.5%) eyes, pressure was controlled by using one or two eye drops. The mean number of preoperative anti-glaucoma medications (2.38; SD 1.1) was reduced compared to the mean number of postoperative medications (1.92; SD 0.9) at 12 weeks.Conclusion:We succeeded in reducing visual disabilities and the number of anti-glaucoma medications used to treat refractory glaucoma by AGV surgery.

The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences in Southwest Ethiopia

“…A success rate of 76.9% at 6 month was reported in another study from Ethiopia ( 9 ), while a 79% success in a 2 months' follow-up has been reported among patients from Kenya (using iCare and Goldman applanation tonometers) ( 8 ). A cumulative probability of success ranging from 66% – 94% at 12 month has also been reported from Asia and other regions of the world ( 5 , 11 – 14 ).…”

Neovascular Glaucoma Progress and Impact of Therapeutic Intervention in Saudi Arabia

“…A high prevalence of diabetes and diabetic retinopathy among the Middle Eastern population should be noted as the risk of neovascular glaucoma is also high [ 30 , 31 ]. The management with Ahmed valve for refractory glaucoma including NVG is not promising in Arab patients [ 32 ]. This matches with the outcomes of the present study.…”

Ahmed valve in glaucoma surgery

“…M. Shah и соавт. [16] провели анализ результатов ИКА у взрослого арабского населения с рефрактерной глаукомой в Омане и сообщили о 12% абсолютной и 78% относительной успешности компенсации ВГД в сроки наблюдения до 6 мес. K. Ishida и P. Netland [17] отметили, что пациенты афроамериканской расы чаще сталкивались с отсутствием эффекта от ИКА, особенно при неоваскулярной и ранее оперированной глаукоме.…”