title: Pars Plana-Modified versus Conventional Ahmed Glaucoma Valve in Patients Undergoing Penetrating Keratoplasty: A Prospective Comparative Randomized Study.
abstract: To compare the outcome of pars-plana-modified Ahmed glaucoma valve (AGV) versus limbal-based conventional AGV into the anterior chamber, in patients undergoing penetrating keratoplasty (PK) for glaucoma with coexisting corneal diseases.
  
  
  
  In this prospective randomized clinical trial, 58 eyes of 58 patients with glaucoma and coexisting corneal disease were divided into two groups. Group 1 (29 eyes of 29 patients) included patients undergoing limbal-based conventional AGV into the anterior chamber (AC) along-with PK and group 2 (29 eyes of 29 patients) included those undergoing pars-plana-modified AGV along-with PK. Outcome measures included corneal graft clarity, intraocular pressure (IOP), number of antiglaucoma medications, and postoperative complications. Patients were followed up for a minimum period of 2 years.
  
  
  
  Out of 58 eyes (58 patients), 50 eyes (50 patients: 25 eyes of 25 patients each in group 1 and group 2) completed the study and were analyzed. Complete success rate for AGV (group 1: 76%; group 2: 72%; p = 0.842) and corneal graft clarity (group 1: 68%; group 2: 76%; p = 0.081) were comparable between the two groups at 2 years. Graft failure was more in conventional AGV (32%) as compared to pars plana-modified AGV (24%) but not statistically significant (p = 0.078) at 2 years.
  
  
  
  Though both procedures were comparable in various outcome measures, pars-plana-modified AGV is a viable option for patients undergoing PK, as it provides a relatively better corneal graft survival rate and lesser complications that were associated with conventional AGV.
authors.affiliation: a Department of Ophthalmology , Army Hospital Research and Referral , Delhi Cantt . India.
authors.forename: Jitendra Kumar Singh
authors.initials: JK
authors.lastname: Parihar
authors.affiliation: b Department of Ophthalmology , Uttar Pradesh Rural Institute of Medical Sciences & Research , Saifai , Etawah , India.
authors.forename: Vaibhav Kumar
authors.initials: VK
authors.lastname: Jain
authors.affiliation: c Department of Ophthalmology , Advance Eye Centre, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Jaya
authors.initials: J
authors.lastname: Kaushik
authors.affiliation: d Department of Ophthalmology , Command Hospital (EC) , Kolkata , West Bengal , India.
authors.forename: Avinash
authors.initials: A
authors.lastname: Mishra
mesh_terms: D000867:Anterior Chamber / Q000601:surgery*; D003316:Corneal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D018463:Filtering Surgery / Q000379:methods*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Ahmed glaucoma valve (AGV); glaucoma drainage device (GDD); glaucoma with coexisting corneal diseases; pars plana clip; pars plana-modified AGV; penetrating keratoplasty