[Intermediate-term and long-term clinical evaluation of the Ahmed glaucoma valve implantation].
OBJECTIVE
To evaluate the Intermediate-term and long-term clinical results of Ahmed glaucoma valve (AGV) implantation in refractory glaucoma.


METHODS
A retrospective study was conducted to document 221 eyes from 206 patients with refractory glaucoma who undergone AGV implantation or combined AGV implantation with other intraocular surgery. The subject had a minimum 6 months of follow-up after surgery. According to the successful definition of AGV implantation, life table's analysis was used to assess the cumulative probabilities of success in different follow-up time. Cox regression analysis was performed to estimate the relationships between survival outcomes and multiple predictors.


RESULTS
The follow-up ranged from 6.03 to 86.30 months (mean 36.86 months). The cumulative probabilities of success at 0.5, 1, 2, 3, and 4 years were (88.5 +/- 2.2)%, (85.0 +/- 2.5)%, (76.4 +/- 3.1)%, (66.2 +/- 3.7)%, (55.5 +/- 4.7)% and of total success at 0.5, 1, 2, 3, and 4 years were (91.2 +/- 1.9)%, (88.6 +/- 2.2)%, (88.6 +/- 2.2)%, (86.8 +/- 2.5)%, (86.8 +/- 2.5)%, respectively. Intraocular pressure was reduced from a preoperative mean of (44.59 +/- 13.04) mm Hg (1 mm Hg = 0.133 kPa) to a postoperative mean of (16.52 +/- 4.61) mm Hg (P < 0.01). The early major complications included transient hypotony (19.5%), shallow anterior chamber (14.5%), tube blockage (11.3%), hemorrhage (7.2%). The late major complications were encapsulated bleb (10.9%), exposure of tube (5.0%), tube malposition (4.5%), corneal decompensation (2.3%), extrusion of implant (1.4%).


CONCLUSIONS
AGV or combined AGV with other intraocular surgery is effective and relatively safe method for treating refractory glaucoma. The rates of success can be increased by means of effective management of the complications.
Chen
Hong
H
Beijing Tongren Ophthalmic Center, Capital University of Medical Sciences. Beijing 100730, China. chenhong1@trhos.com
Zhang
Shu-xin
SX
Liu
Lei
L
Lin
Ding
D
Tang
Xin
X
Sun
Li
L
Wang
Tao
T
Wang
Hua
H
Wang
Ning-li
NL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D016016:Proportional Hazards Models; D019919:Prosthesis Implantation / Q000379:methods / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity