Article

Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma.

Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
The British journal of ophthalmology (impact factor: 2.92). 08/2009; 93(11):1504-9. DOI:10.1136/bjo.2008.150870
Source: PubMed

ABSTRACT To compare the long-term intraocular pressure (IOP) outcomes of Ahmed Glaucoma Valve (AGV) implantation to trabeculectomy with mitomycin C (MMC) in open-angle glaucoma (OAG).
78 OAG patients who underwent AGV implantation were matched with respect to age, preoperative surgery, preoperative IOP and preoperative medicines to 88 OAG patients who underwent trabeculectomy with MMC with a minimum of 3 years' follow-up. The cumulative probability of success between the two groups with different criteria was analysed: (1) an IOP < or =21 mm Hg and a reduction of IOP>/=15% from baseline; and (2) an IOP < or =18 mm Hg and a reduction of IOP > or =20% from baseline. No loss of light perception, no additional glaucoma surgery and no hypotony were also required.
The 5-year cumulative probability of success was not statistically significant between eyes that had an AGV or trabeculectomy with MMC when success was defined as criteria A (p = 0.094). However, when success was defined according to criteria B, eyes undergoing trabeculectomy with MMC had a higher rate of success (p = 0.024).
Trabeculectomy with MMC has a significantly higher 5-year cumulative probability of success compared with AGV implants when greater reduction IOP is necessary.

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Keywords

3 years' follow-up
 
5-year cumulative probability
 
78 OAG patients
 
88 OAG patients
 
additional glaucoma surgery
 
AGV implantation
 
Ahmed Glaucoma Valve
 
criteria B
 
cumulative probability
 
different criteria
 
eyes undergoing trabeculectomy
 
greater reduction IOP
 
higher 5-year cumulative probability
 
higher rate
 
long-term intraocular pressure
 
mitomycin C
 
open-angle glaucoma
 
preoperative IOP
 
Trabeculectomy
 
two groups