Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma.
OBJECTIVE
To compare the long-term intraocular pressure (IOP) outcomes of Ahmed Glaucoma Valve (AGV) implantation to trabeculectomy with mitomycin C (MMC) in open-angle glaucoma (OAG).


METHODS
78 OAG patients who underwent AGV implantation were matched with respect to age, preoperative surgery, preoperative IOP and preoperative medicines to 88 OAG patients who underwent trabeculectomy with MMC with a minimum of 3 years' follow-up. The cumulative probability of success between the two groups with different criteria was analysed: (1) an IOP < or =21 mm Hg and a reduction of IOP>/=15% from baseline; and (2) an IOP < or =18 mm Hg and a reduction of IOP > or =20% from baseline. No loss of light perception, no additional glaucoma surgery and no hypotony were also required.


RESULTS
The 5-year cumulative probability of success was not statistically significant between eyes that had an AGV or trabeculectomy with MMC when success was defined as criteria A (p = 0.094). However, when success was defined according to criteria B, eyes undergoing trabeculectomy with MMC had a higher rate of success (p = 0.024).


CONCLUSIONS
Trabeculectomy with MMC has a significantly higher 5-year cumulative probability of success compared with AGV implants when greater reduction IOP is necessary.
Tran
D H
DH
Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
Souza
C
C
Ang
M J
MJ
Loman
J
J
Law
S K
SK
Coleman
A L
AL
Caprioli
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007430:Intraoperative Care; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome