Long-term Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma at Farabi Eye Hospital, Tehran, Iran

• Published in: Middle East African journal of ophthalmology Vol. 23; no. 1; pp. 104 - 109
• Main Authors: Zarei, Reza, Amini, Heidar, Daneshvar, Ramin, Nabi, Fahimeh Naderi, Moghimi, Sasan, Fakhraee, Ghasem, Eslami, Yadollah, Mohammadi, Masoud, Amini, Nima
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-01-2016; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Adolescent; Adult; Aged; Antihypertensive Agents - administration & dosage; Care and treatment; Child; Cohort Studies; Dosage and administration; Failure; Female; Follow-Up Studies; Glaucoma; Glaucoma - physiopathology; Glaucoma - surgery; Glaucoma Drainage Implants; Hospitals; Hospitals, Special; Humans; Intraocular Pressure - physiology; Iran; Male; Middle Aged; Ophthalmic agents; Ophthalmology; Original; Postoperative Complications; Prosthesis Implantation; Retrospective Studies; Studies; Success; Surgery; Surgical outcomes; Survival analysis; Tonometry, Ocular; Transplants & implants; Treatment Outcome; Variance analysis; Young Adult; Iran; Middle East; Glaucoma Drainage Implant; Ahmed Glaucoma Valve; Intraocular Pressure; Refractory Glaucoma
• ISSN: 0974-9233; 0975-1599; 0975-1599; 0974-9233
• DOI: 10.4103/0974-9233.164611

To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran.
This retrospective cohort study evaluated patient records of all subjects with refractory glaucoma who had undergone AGV implantation up to January 2013. The main outcome measure was the surgical success rate. Complete success was defined as intraocular pressure (IOP) <22 mmHg, without anti-glaucoma medications or additional surgery. Qualified success was IOP <22 mmHg regardless of number of anti-glaucoma medications. In all cases, loss of vision (no light perception) was considered an independent indicator of failure. Data were also collected on intraoperative and postoperative complications.
Twenty-eight eyes were included in the study. With a mean follow-up of 48.2 ± 31.7 months (median: 40.50 months; range: 3-124 months), the IOP decreased from a mean preoperative value of 30.8 ± 5.6 mmHg to 20.0 ± 6.4 mmHg at last visit. The number of medications decreased from 3.7 ± 0.4 preoperatively to 2.5 ± 1.1 postoperatively. Cumulative qualified success was achieved in 69% of eyes. Mean time to failure according to qualified success criteria was 92.3 ± 9.4 months. Postoperative complications were recorded in 16 (57.1%) eyes. The most common complication was focal endothelial corneal decompensation at the site of tube-cornea touch.
AGV implantation with adjunctive topical anti-glaucoma drops controlled IOP in approximately 70% of eyes with refractory glaucoma with a median of 40.5 months of follow-up. However, complication rates were higher.