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

Zarei R, Amini H, Daneshvar R, Nabi FN, Moghimi S, Fakhraee G, Eslami Y, Mohammadi M, Amini N - Middle East Afr J Ophthalmol (2016 Jan-Mar)

Bottom Line: The main outcome measure was the surgical success rate.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.

View Article: PubMed Central - PubMed

Affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Purpose: To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

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Survival curve of complete success following Ahmed glaucoma valve implantation in 28 eyes with refractory glaucoma (a) complete success, (b) qualified success
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Figure 1: Survival curve of complete success following Ahmed glaucoma valve implantation in 28 eyes with refractory glaucoma (a) complete success, (b) qualified success

Mentions: In life-table survival analysis and based on the predefined success criteria, qualified success was achieved in 69% of subjects at the end of 120 months of follow-up. The mean ± standard error of mean time to failure according to complete and qualified success criteria was 51.6 ± 6.8 months and 92.3 ± 9.4 months, respectively [Figure 1].


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

Zarei R, Amini H, Daneshvar R, Nabi FN, Moghimi S, Fakhraee G, Eslami Y, Mohammadi M, Amini N - Middle East Afr J Ophthalmol (2016 Jan-Mar)

Survival curve of complete success following Ahmed glaucoma valve implantation in 28 eyes with refractory glaucoma (a) complete success, (b) qualified success
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4759886&req=5

Figure 1: Survival curve of complete success following Ahmed glaucoma valve implantation in 28 eyes with refractory glaucoma (a) complete success, (b) qualified success
Mentions: In life-table survival analysis and based on the predefined success criteria, qualified success was achieved in 69% of subjects at the end of 120 months of follow-up. The mean ± standard error of mean time to failure according to complete and qualified success criteria was 51.6 ± 6.8 months and 92.3 ± 9.4 months, respectively [Figure 1].

Bottom Line: The main outcome measure was the surgical success rate.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.

View Article: PubMed Central - PubMed

Affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Purpose: To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Show MeSH
Related in: MedlinePlus