Safety and efficacy of Ahmed glaucoma valve implantation in refractory glaucomas in Northern Indian eyes.
OBJECTIVE
To evaluate the safety and efficacy of Ahmed glaucoma valve (AGV) implantation in refractory glaucoma in Northern Indian eyes.


BACKGROUND
The success rate of trabeculectomy remains low in cases of refractory glaucoma even with the use of antifibrotics. Glaucoma drainage devices have proven to be more efficacious in reducing intraocular pressure (IOP) in these glaucomas.


METHODS
Retrospective records of 55 consecutive patients who underwent AGV implantation at Dr. Shroff's Charity Eye Hospital, New Delhi, India from January 2003 to December 2012 were reviewed. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications, number of prior incisional surgeries, visual acuity and IOP on medical treatment. Postoperative data included visual acuity and IOP on day one, 1 week, 1 month, 3 months, 6 months, 1 year and yearly thereafter, number of anti-glaucoma medications, any complication or additional surgical intervention required. Success was defined as IOP >5 and <22 mmHg with or without treatment.


RESULTS
Mean IOP decreased from 39.71 ± 8.99 pre-operatively to 17.52 ± 5.72 mmHg at last follow-up (p < 0.001) and number of medications reduced from 3.27 ± 0.84 to 1.25 ± 0.88 (p < 0.001). Visual acuity remained within one Snellen line or improved at last follow-up in 47 cases (85.4%). The cumulative probability of success was 85.45% at 1 year and 79.63% at 3 years. The incidence of post-operative complications was 25.45%.


CONCLUSIONS
AGV implantation has proven to be safe and is effective in controlling IOP in refractory glaucoma in Northern Indian eyes.
Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi 110002, India.
Suneeta
S
Dubey
Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi 110002, India.
Vijeta
V
Sharma
Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi 110002, India.
Anugya
A
Agrawal
Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi 110002, India.
Lokesh
L
Chauhan
University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
Gordon
G
Douglas
Ahmed glaucoma valve; Intraocular pressure; Refractory glaucoma