title: Achieving Target Pressures with Combined Surgery: Primary Patchless Ahmed Valve Combined with Phacoemulsification vs Primary Phacotrabeculectomy.
abstract: OBJECTIVE
  To evaluate the ability of phacoemulsification combined with either primary trabeculectomy (PT) or primary Ahmed glaucoma valve implantation (PAVI) to achieve target intraocular pressures (TIOP) in adults with primary open angle glaucoma.
  
  
  METHODS
  Chart review of 214 adult patients operated between January 2002 and June 2008 with a minimum follow-up of 6 months. Group 1 comprised 181 eyes of 166 patients undergoing PT while group 2 included 50 eyes of 49 patients in combination with primary AVI. Target lOPs were pre-determined for each patient and success was defined as an IOP at or lower than target with or without medications. An IOP above target, loss of light perception or need for additional procedures to lower IOP were considered a failure.
  
  
  RESULTS
  Mean preoperative IOP was 17.2 mm Hg in group 1 and 17.3 in group 2. Mean postoperative IOPs were 10.2 and 9.2 on day 1, 12.2 and 11.6 at year 1, and 10.7 in both groups at year 5. Survival rates in groups 1 and 2 were 96.7 vs 96% at 6 months, 89 vs 96% at 12 months, 83.5 vs 96% at 24 months and 79.4 vs 89.1% at 36, 48 and 72 months. Transient bleb leaks were more frequent in group 1 (26 eyes, 14.4 vs 0%, p = 0.001) and transient choroidal detachments were more frequent in group 2 (7 eyes, 3.9 vs 6 eyes, 12%, p = 0.038).
  
  
  CONCLUSIONS
  Midterm results for achieving target pressures using combined phacoemulsification with either PT or PAVI are comparable. The profile of complications is different for the two procedures. How to cite this article: Albis-Donado O, Sánchez-Noguera CC, Cárdenas-Gómez L, Castañeda-Diez R, Thomas R, Gil-Carrasco F. Achieving Target Pressures with Combined Surgery: Primary Patchless Ahmed Valve Combined with Phacoemulsification vs Primary Phacotrabeculectomy. J Curr Glaucoma Pract 2015;9(1):6-11.
authors.affiliation: Department of Glaucoma, Mexican Institute of Ophthalmology Queretaro, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Albis-Donado
authors.affiliation: Department of Glaucoma, Association for the Prevention of Blindness, Coyoacan, Mexico.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Sánchez-Noguera
authors.affiliation: Department of Glaucoma, Association for the Prevention of Blindness, Coyoacan, Mexico.
authors.forename: Lorena
authors.initials: L
authors.lastname: Cárdenas-Gómez
authors.affiliation: Department of Glaucoma, Association for the Prevention of Blindness, Coyoacan, Mexico.
authors.forename: Rafael
authors.initials: R
authors.lastname: Castañeda-Diez
authors.affiliation: Department of Glaucoma, Cataract, Clinical Epidemiology Queensland Eye Institute, Melbourne, Australia.
authors.forename: Ravi
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Department of Glaucoma, Association for the Prevention of Blindness, Coyoacan, Mexico.
authors.forename: Félix
authors.initials: F
authors.lastname: Gil-Carrasco
keywords: Ahmed valve; Cataract; Combined surgery; Glaucoma; Phacoemulsification; Target pressure.; Trabeculectomy