Comparison of the Ahmed Glaucoma Valve, the Krupin Eye Valve with Disk, and the double-plate Molteno implant.
OBJECTIVE
To compare the efficacy of the nonvalved double-plate Molteno implant with two valved implants, the Krupin Eye Valve with Disc and the Ahmed Glaucoma Valve, in the treatment of recalcitrant glaucoma.


METHODS
The authors performed a nonrandomized retrospective review of patients who received the Molteno implant (n = 27), Krupin Eye Valve with Disc (n = 13), or Ahmed Glaucoma Valve (n = 13), with adjunctive mitomycin C.


RESULTS
Kaplan-Meier life-table analysis showed that the Molteno implant patients were more likely to maintain an intraocular pressure between 5 and 15 mm Hg than Ahmed Glaucoma Valve patients (P = 0.03). Success rates at 1 year were 80% (95% CI, 66-97%) for the Molteno implant, 39% (19-77%) for the Krupin Eye Valve with Disc, and 35% (15-82%) for the Ahmed Glaucoma Valve. However, Ahmed Glaucoma Valve patients were less likely to experience complications requiring reoperation or loss of two or more lines of visual acuity (P < 0.01) than Molteno implant or Krupin Eye Valve with Disc patients.


CONCLUSIONS
This nonrandomized study suggests that the Molteno implant with mitomycin C is more likely to result in intraocular pressures in the lower teens than the Ahmed Glaucoma Valve with mitomycin C. The findings suggest that the Ahmed implant is less likely to create problems leading to reoperations or visual acuity loss than the Molteno or Krupin implants.
Taglia
Daniel P
DP
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin 53705-3631, USA.
Perkins
Todd W
TW
Gangnon
Ronald
R
Heatley
Gregg A
GA
Kaufman
Paul L
PL
D000328:Adult; D000368:Aged; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D015993:Life Tables; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D018465:Molteno Implants; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D016685:Mitomycin