title: Effect of early treatment with aqueous suppressants on Ahmed glaucoma valve implantation outcomes.
abstract: To evaluate the effect of early aqueous suppressant treatment on Ahmed glaucoma valve (AGV) surgery outcomes.
  
  
  
  Randomized clinical trial.
  
  
  
  Ninety-four eyes of 94 patients with refractory glaucoma.
  
  
  
  After AGV implantation, 47 cases (group 1) received topical timolol-dorzolamide fixed-combination drops twice daily when intraocular pressure (IOP) exceeded 10 mmHg, whereas 47 controls (group 2) received conventional stepwise treatment when IOP exceeded target pressure.
  
  
  
  Main outcome measures included IOP and success rate (6 mmHg < IOP < 15 mmHg and IOP reduction of at least 30% from baseline). Other outcome measures included best-corrected visual acuity, complications, and hypertensive phase frequency.
  
  
  
  Groups 1 and 2 were both followed up for a mean of 45±11.6 and 47.2±7.4 weeks, respectively (P = 0.74). Mixed model analysis revealed a significantly greater IOP reduction in group 1 at all intervals (P<0.001). At 1 year, the cases exhibited a significantly higher success rate (63.2% vs. 33.3%; P = 0.008) and reduced hypertensive phase frequency (23.4% vs. 66.0%; P<0.001).
  
  
  
  Early aqueous suppressant treatment may improve AGV implantation outcomes in terms of IOP reduction, success rate, and hypertensive phase frequency.
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mohpakravan@icloud.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Pakravan
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shahram Salehi
authors.initials: SS
authors.lastname: Rad
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Yazdani
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Ghahari
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yaseri
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000187:drug effects; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000628:therapy*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000517:prevention & control; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D013999:Timolol / Q000627:therapeutic use*; D014792:Visual Acuity
chemical_list: D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D004338:Drug Combinations; D013449:Sulfonamides; D013876:Thiophenes; D013999:Timolol; C062765:dorzolamide