title: Comparison of safety and efficacy between silicone and polypropylene Ahmed glaucoma valves in refractory glaucoma.
abstract: OBJECTIVE
  To compare the safety and efficacy of polypropylene and silicone Ahmed glaucoma valves (AGVs) over 1 year of follow-up.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Fifty consecutive patients with polypropylene and 49 consecutive patients with silicone AGV implantation.
  
  
  METHODS
  Our hospital instituted a formulary conversion of the glaucoma aqueous drainage device from polypropylene to silicone AGVs in January 2003. We reviewed the polypropylene AGVs within 7 months before and the silicone AGVs within 7 months after the date of conversion performed on patients with glaucoma refractory to medical treatment and filtering procedures, without previous drainage devices or cyclodestructive procedures, and with a minimum of 12 months' follow-up. Surgical success was defined as an intraocular pressure (IOP) reduction of > or =20% and a final IOP of >5 and <22 mmHg, without additional surgical intervention for IOP control, loss of light perception, or serious complications.
  
  
  METHODS
  The 2 groups were compared for IOP control, visual outcome, complication rate, and surgical success rate.
  
  
  RESULTS
  Significant IOP reductions occurred after polypropylene AGV implantation (from 32.4+/-11.3 mmHg to 16.5+/-6.9 mmHg, P<0.0001) and silicone AGV implantation (from 32.6+/-12.6 mmHg to 14.7+/-6.9 mmHg, P<0.0001). The silicone group had a lower mean IOP than the polypropylene group at all postoperative visits, but the differences were significant only at 3 months postoperatively (P = 0.014). In addition, the silicone group was associated with a rate of insufficient IOP control as the reason of failure (IOP of > or =22 mmHg or IOP reduction of <20%) lower (4.1%) than that of the polypropylene group (20.0%, P = 0.015), but a rate of non-tube related serious complications (16.3%) higher than that of the polypropylene AGV (4.0%, P = 0.042).
  
  
  CONCLUSIONS
  After 1 year of follow-up, the silicone AGV is at least as effective as the polypropylene AGV in IOP reduction but may be associated with a higher rate of complications. These differences are important for surgeons converting to use of the silicone AGV in patients with glaucoma refractory to other forms of treatment.
authors: Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, California 90095, USA. law@jsei.ucla.edu
authors: Simon K
authors: SK
authors: Law
authors: Anne
authors: A
authors: Nguyen
authors: Anne L
authors: AL
authors: Coleman
authors: Joseph
authors: J
authors: Caprioli
mesh_terms: D000368:Aged; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D011126:Polypropylenes; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012008:Recurrence; D012189:Retrospective Studies; D012826:Silicone Elastomers; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D011126:Polypropylenes; D012826:Silicone Elastomers