Comparing Ahmed-FP7 to Baerveldt-250 and Baerveldt-350 surgical outcomes: 1-year results from a retrospective cohort study leveraging the electronic health record

• Published in: BMJ open ophthalmology Vol. 8; no. 1; p. e001308
• Main Authors: Shen, Leo L, Guo, Xinxing, Johnson, Thomas V, Friedman, David, Boland, Michael V, McGlumphy, Elyse J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01-06-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Cataracts; Cohort analysis; Corneal transplantation; Electronic Health Records; Follow-Up Studies; Glaucoma; Glaucoma - surgery; Glaucoma Drainage Implants; Humans; Intraocular Pressure; Patients; Postoperative Complications - surgery; Prosthesis Implantation - methods; Retrospective Studies; Surgeons; Surgery; Surgical outcomes; Text analysis; Treatment Outcome; Treatment Surgery; Variance analysis; Vision; Visual Acuity; United States > US; California; Glaucoma; Vision; Treatment Surgery
• DOI: 10.1136/bmjophth-2023-001308
• EISSN: 2397-3269

ObjectiveTo compare outcomes following Ahmed-FP7 (AGI-FP7), Baerveldt-250mm2 (BGI-250), or Baerveldt-350mm2 (BGI-350) implantation.Methods and analysisRetrospective cohort study comprising 800 eyes from 800 individuals who underwent surgery 1 January 2016–31 December 2020 at a tertiary-care institution. Data were extracted from standardised fields in the electronic health record. Primary outcome was failure (defined as intraocular pressure (IOP) ≤5 mm Hg or >18 mm Hg or reduction <20% at two consecutive visits from month 3 onwards; or visual acuity (VA) loss ≥3 lines; or return to the operating room (OR)). Secondary outcomes were IOP, VA, number of follow-up visits and return to the OR.ResultsA total of 523 AGI-FP7, 133 BGI-250 and 144 BGI-350 cases were analysed. The AGI-FP7 group was more likely to be younger and diagnosed with secondary glaucoma, with a higher mean baseline IOP (28.5±12.2 vs 22.0±7.7 mm Hg in BGI-250 and 23.4±9.0 in BGI-350, p<0.001). Cumulative failure rate at month 12 was 30% (AGI-FP7) vs 39% (BGI-250) vs 33% (BGI-350, p=0.159). Mean IOP at month 12 was lower in the BGI-350 group compared with AGI-FP7 (12.4±4.4 vs 14.8±5.6 mm Hg, p=0.003) but not BGI-250 (vs 13.1±4.6, p=0.710). Target IOP was achieved in 71% of AGI-FP7, 66% BGI-250, and 76% BGI-350. VA loss and rates of return to the OR did not differ between groups. Both BGI-250 and BGI-350 had more follow-up visits than AGI-FP7 (p<0.001).ConclusionThese three glaucoma drainage devices performed similarly within 1 year, with no difference in failure rates despite differing baseline patient characteristics.