title: Long-term Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma at Farabi Eye Hospital, Tehran, Iran.
abstract: OBJECTIVE
  To describe long-term outcomes and complications of Ahmed glaucoma valve (AGV) implantation in subjects with refractory glaucoma at Farabi Eye Hospital, Tehran, Iran.
  
  
  METHODS
  This retrospective cohort study evaluated patient records of all subjects with refractory glaucoma who had undergone AGV implantation up to January 2013. The main outcome measure was the surgical success rate. Complete success was defined as intraocular pressure (IOP) <22 mmHg, without anti-glaucoma medications or additional surgery. Qualified success was IOP <22 mmHg regardless of number of anti-glaucoma medications. In all cases, loss of vision (no light perception) was considered an independent indicator of failure. Data were also collected on intraoperative and postoperative complications.
  
  
  RESULTS
  Twenty-eight eyes were included in the study. With a mean follow-up of 48.2 ± 31.7 months (median: 40.50 months; range: 3-124 months), the IOP decreased from a mean preoperative value of 30.8 ± 5.6 mmHg to 20.0 ± 6.4 mmHg at last visit. The number of medications decreased from 3.7 ± 0.4 preoperatively to 2.5 ± 1.1 postoperatively. Cumulative qualified success was achieved in 69% of eyes. Mean time to failure according to qualified success criteria was 92.3 ± 9.4 months. Postoperative complications were recorded in 16 (57.1%) eyes. The most common complication was focal endothelial corneal decompensation at the site of tube-cornea touch.
  
  
  CONCLUSIONS
  AGV implantation with adjunctive topical anti-glaucoma drops controlled IOP in approximately 70% of eyes with refractory glaucoma with a median of 40.5 months of follow-up. However, complication rates were higher.
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Zarei
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Heidar
authors.initials: H
authors.lastname: Amini
authors.affiliation: Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Daneshvar
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fahimeh Naderi
authors.initials: FN
authors.lastname: Nabi
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sasan
authors.initials: S
authors.lastname: Moghimi
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ghasem
authors.initials: G
authors.lastname: Fakhraee
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Eslami
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Mohammadi
authors.affiliation: Department of Health Sciences, California State University, Northridge and Translational Pathology Core Laboratory, University of California, Los Angeles, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Amini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006782:Hospitals, Special; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007492:Iran; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: Ahmed Glaucoma Valve; Glaucoma Drainage Implant; Intraocular Pressure; Refractory Glaucoma