Evaluating the Effectiveness of Ahmed Glaucoma Valve Implantation in Reducing Intraocular Pressure in Refractory Glaucoma in the Saudi Arabian Population at a Tertiary Care Centre
DOI:
https://doi.org/10.22317/jcms.v10i5.1615Abstract
Objectives: To assess the efficacy of Ahmed glaucoma valve implantation (AGVI) in lowering intraocular pressure (IOP) in patients with refractory glaucoma.
Methods: In this retrospective study, we analyzed the medical records of 60 patients who received AGVI for refractory glaucoma. Data collected included demographics, type of glaucoma, preoperative and postoperative IOP, number of glaucoma medications, and any surgical complications. Success was defined as achieving an IOP <21 mmHg at the final follow-up visit.
Results: At the final follow-up (mean duration of 11.6 months), AGVI achieved successful IOP control (IOP of <21 mmHg) in 40 eyes (66.7%). The mean number of glaucoma medications decreased significantly from 2.95 preoperatively to 1.98 postoperatively (p < 0.001). Neovascular glaucoma (NVG) had a lower success rate compared to other types of glaucoma. Prior glaucoma surgery was associated with a higher risk of failing to reach target IOP, although this trend was not statistically significant (p = 0.108).
Conclusion: AGVI implantation effectively lowered IOP in patients with refractory glaucoma, especially in the short term. However, long-term success rates were lower, and NVG showed less favorable outcomes. AGVI is a valuable option for managing refractory glaucoma, but careful patient selection is essential. Further research is needed to evaluate long-term efficacy and refine treatment strategies.
References
Riva I, Roberti G, Katsanos A, Oddone F, Quaranta L. A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations. Adv Ther. 2017;34(4):834-847. doi:10.1007/s12325-017-0503-1
Souza C, Tran DH, Loman J, Law SK, Coleman AL, Caprioli J. Long-term outcomes of Ahmed glaucoma valve implantation in refractory glaucomas. Am J Ophthalmol. 2007;144(6):893-900. doi:10.1016/j.ajo.2007.07.035
Zarei R, Amini H, Daneshvar R, et al. Long-term Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma at Farabi Eye Hospital, Tehran, Iran. Middle East Afr J Ophthalmol. 2016;23(1):104-109. doi:10.4103/0974-9233.164611
Lin M, Alizadeh R, Law SK. Outcomes of Combined Ahmed Glaucoma Valve and Trabeculectomy Revision With Adjunctive Antimetabolite. J Glaucoma. 2019;28(5):404-410. doi:10.1097/IJG.0000000000001135
Lee CK, Ma KT, Hong YJ, Kim CY. Long-term clinical outcomes of Ahmed valve implantation in patients with refractory glaucoma. PLoS One. 2017;12(11):e0187533. Published 2017 Nov 2. doi:10.1371/journal.pone.0187533
Nilforushan N, Abolfathzadeh N, Miraftabi A, Banifatemi M. Outcomes of Trabeculectomy and Ahmed Glaucoma Valve Implantation in Patients With Iridocorneal Endothelial Syndrome. J Glaucoma. 2024;33(7):e35-e42. doi:10.1097/IJG.0000000000002375
HaiBo T, Xin K, ShiHeng L, Lin L. Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis. PLoS One. 2015;10(2):e0118142. Published 2015 Feb 26. doi:10.1371/journal.pone.0118142
Arikan G, Gunenc U. Ahmed Glaucoma Valve Implantation to Reduce Intraocular Pressure: Updated Perspectives. Clin Ophthalmol. 2023;17:1833-1845; https://doi.org/10.2147/OPTH.S342721
Furashova O, Pillunat K, Spoerl E, Pillunat L. Long-term results after Ahmed glaucoma valve implantation for different types of glaucoma. IOVS. 54 (15)2013. Available from: https://iovs.arvojournals.org/article.aspx?articleid=2149679.
Alasbali T, Alghamdi AA, Khandekar R. Outcomes of Ahmed valve surgery for refractory glaucoma in Dhahran, Saudi Arabia. Int J Ophthalmol. 2015;8(3):560-564. Published 2015 Jun 18. doi:10.3980/j.issn.2222-3959.2015.03.22
Hong M, Peng Y, Lai Y, Zheng Q, Hong C. Comparison of Aurolab Aqueous Drainage Implant with Ahmed Glaucoma Valve for Refractory Glaucoma: A Meta-Analysis. Ophthalmic Res. 2023;66(1):457-464. doi:10.1159/000529039
Kaya, M., Ozbek, Z., Yaman, A., & Durak, I. (2012). Long-term success of ahmed glaucoma valve in refractory glaucoma. International journal of ophthalmology, 5(1), 108–112. https://doi.org/10.3980/j.issn.2222-3959.2012.01.22
He, Ye MD, PhDa; Tian, Ying MD, PhDa; Song, Weitao MD, PhDa; Su, Ting MD, PhDb; Jiang, Haibo MD, PhDa; Xia, Xiaobo MD, PhDa,*. Clinical efficacy analysis of Ahmed glaucoma valve implantation in neovascular glaucoma and influencing factors: A STROBE-compliant article. Medicine 96(42):p e8350, October 2017. | DOI: 10.1097/MD.0000000000008350 14.
Gedar Totuk, O.M., Kabadayi, K., Colakoglu, A. et al. A novel surgical technique for prevention of Ahmed glaucoma valve tube exposure: long scleral flap augmented with Tenon advancement and duplication. BMC Ophthalmol 18, 226 (2018). https://doi.org/10.1186/s12886-018-0907-y
Christakis PG, Kalenak JW, Tsai JC, et al. The Ahmed Versus Baerveldt Study: Five-Year Treatment Outcomes. Ophthalmology. 2016;123(10):2093-2102. doi:10.1016/j.ophtha.2016.06.035
Posarelli, C., Toro, M. D., Rejdak, R., Żarnowski, T., Pożarowska, D., Longo, A., Miccoli, M., Nardi, M., & Figus, M. (2020). Safety and Efficacy of Second Ahmed Valve Implant in Refractory Glaucoma. Journal of clinical medicine, 9(7), 2039. https://doi.org/10.3390/jcm9072039
Wang, S., Gao, X., & Qian, N. (2016). The Ahmed shunt versus the Baerveldt shunt for refractory glaucoma: a meta-analysis. BMC ophthalmology, 16, 83. https://doi.org/10.1186/s12886-016-0265-6
Christakis PG, Kalenak JW, Tsai JC, et al. The Ahmed Versus Baerveldt Study: Five-Year Treatment Outcomes. Ophthalmology. 2016;123(10):2093-2102. doi:10.1016/j.ophtha.2016.06.035
Posarelli, C., Toro, M. D., Rejdak, R., Żarnowski, T., Pożarowska, D., Longo, A., Miccoli, M., Nardi, M., & Figus, M. (2020). Safety and Efficacy of Second Ahmed Valve Implant in Refractory Glaucoma. Journal of clinical medicine, 9(7), 2039. https://doi.org/10.3390/jcm9072039
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Journal of Contemporary Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.