Ahmed glaucoma valve implantation in uveitic glaucoma versus open-angle glaucoma patients.
BACKGROUND
The poor long-term success rate of repeat trabeculectomies in refractory uveitic glaucoma (UG) patients has led to the use of glaucoma drainage devices (GDDs). However, the success and complication rates of GDDs in UG patients utilizing a control group with standard demographic data, design, and surgical technique have never been evaluated.


METHODS
Fifteen patients (15 eyes) with chronic uveitis and 53 patients (53 eyes) with uncontrolled open-angle glaucoma (OAG) who underwent Ahmed glaucoma valve (AGV) implantation were included in a retrospective, comparative, case-controlled study. Postoperative intraocular pressure (IOP), number of antiglaucoma medications, visual acuity, and complications were compared.


RESULTS
There was a significant difference between the UG versus the OAG group with respect to age only (59.3 years vs 68.4 years, p = 0.006). Regression analysis of the postoperative IOP controlled for age and glaucoma type, and preoperative IOP revealed significantly lower IOP in the UG group at 1 month (p = 0.04; 95% confidence interval [CI] -5.9 to 0.15) and 2 months (p = 0.008; 95% CI -6.0 to 0.97). No significant differences were found at 3, 6, 12, 24, and 30 months. The cumulative success rates at 3 to 30 months for the UG and OAG groups were 80% to 66.6% versus 84.9% to 57% (p = 0.713), respectively. The only complication between the 2 groups that was significantly different was tube removal, which occurred more often in the UG group (p = 0.018).


CONCLUSIONS
AGV implantation is an effective and safe procedure in the management of UG, similar to primary OAG.
Rachmiel
Rony
R
Department of Ophthalmology & Visual Sciences, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. rony.rachmiel@gmail.com
Trope
Graham E
GE
Buys
Yvonne M
YM
Flanagan
John G
JG
Chipman
Mary L
ML
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications / Q000601:surgery*; D014792:Visual Acuity
D000959:Antihypertensive Agents