The efficacy of Ahmed glaucoma valve drainage devices in cases of adult refractory glaucoma in Indian eyes

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Aim:

To evaluate the efficacy of Ahmed glaucoma valve (AGV) drainage devices in cases of adult refractory glaucoma in Indian eyes.

Settings and Design:

Retrospective interventional case series study.

Materials and Methods:

Fifty two eyes of 32 patients of refractory glaucoma in the age group of 35 to 60 years who underwent AGV implantation with or without concomitant procedures from January 2003 to Jan 2007 were studied. Of these, 46 eyes (88%) had undergone filtering surgery earlier whereas remaining eyes underwent primary AGV implantation following failure of maximal medical therapy. The follow up ranged between 12 months to 48 months

Results:

Eighteen eyes (35%) had undergone phacoemulsification with AGV implantation, penetrating keratoplasty (PK) with AGV and intraocular lens (IOL) implantation in 13 eyes (25%), AGV over preexisting IOL in eight eyes (15%). AGV implantation alone was done in six (11%) eyes. Anterior chamber (AC) reconstruction with secondary IOL and AGV was performed in the remaining eyes. The mean intra ocular pressure (IOP) decreased from 36.3 ± 15.7 mm Hg to 19.6 ± 9.2 mm Hg. Complete success as per criteria was achieved in 46 eyes (88%). None of the eyes had failure to maintain IOP control following AGV.

Conclusion:

The AGV resulted in effective and sustained control of IOP in cases of adult refractory glaucoma in intermediate follow up.

Related collections

Most cited references 27

Record: found
Abstract: found
Article: not found

Follow-up of the original cohort with the Ahmed glaucoma valve implant.

Kyle Hill, F Topouzis, Craig Wilson … (1999)

To study the long-term results of the Ahmed glaucoma valve implant in patients with complicated glaucoma in whom short-term results have been reported. In this multicenter study, we analyzed the long-term outcome of a cohort of 60 eyes from 60 patients in whom the Ahmed glaucoma valve was implanted. Failure was characterized by at least one of the following: intraocular pressure greater than 21 mm Hg at both of the last two visits less than 6 mm Hg at both of the last two visits, loss of light perception, additional glaucoma surgery, devastating complications, and removal or replacement of the Ahmed glaucoma valve implant. Devastating complications included chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis, and phthisis bulbi; we also report results that add corneal complications (corneal decompensation or edema, corneal graft failure) as defining a devastating complication. The mean follow-up time for the 60 eyes was 30.5 months (range, 2.1 to 63.5). When corneal complications were included in the definition of failure, 26 eyes (43%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 76%, 68%, 54%, and 45%, respectively. When corneal complications were excluded from the definition of failure, 13 eyes (21.5%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 87%, 82%, 76%, and 76%, respectively. Most of the failures after 12 months of postoperative follow-up were because of corneal complications. The long-term performance of the Ahmed glaucoma valve implant is comparable to other drainage devices. More than 12 months after the implantation of the Ahmed glaucoma valve implant, the most frequent adverse outcome was corneal decompensation or corneal graft failure. These corneal problems may be secondary to the type of eyes that have drainage devices or to the drainage device itself. Further investigation is needed to identify the reasons that corneal problems follow drainage device implantation.

0 comments Cited 55 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Long-term follow-up of primary glaucoma surgery with Ahmed glaucoma valve implant versus trabeculectomy.

M.Roy Wilson, Upali Mendis, Amit Paliwal … (2003)

To compare the long-term results of trabeculectomy and Ahmed glaucoma valve implant in the initial surgical management of primary open- and closed-angle glaucoma. Randomized controlled clinical trial. One eye each of consecutive patients with primary glaucoma and without prior intraocular surgery was randomized to receive either trabeculectomy or the Ahmed implant. Large university-affiliated eye hospital in Columbo, Sri Lanka. Of 123 patients, 64 were randomized to trabeculectomy and 59 to the Ahmed implant. With a mean follow-up of 31 months, the trabeculectomy group had statistically lower intraocular pressures (IOP) during the first postoperative year. After the first year, the IOPs were comparable. No statistically significant differences between groups were noted for postoperative visual acuity, visual field, anterior chamber depth, and short-term or long-term complications. Adjunctive medication requirement was comparable for both groups. The cumulative probabilities of success (IOP <21 mm Hg and at least 15% reduction in IOP from preoperative levels) at the final follow-up period (months, 41-52) were 68.1% for trabeculectomy and 69.8% for Ahmed implant (P =.86). Lower IOPs were noted for the trabeculectomy group during the first year. With longer follow-up, the IOPs and the cumulative probabilities of success were comparable between the two groups.

0 comments Cited 49 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Comparison of polypropylene and silicone Ahmed Glaucoma Valves.

Lineu Shiroma, Mustafa Ahmed, Fatima Khan … (2006)

To evaluate and compare the clinical outcomes after implantation of the silicone plate and the polypropylene plate Ahmed Glaucoma Valves. Prospective, multicenter, comparative series. A total of 132 patients with uncontrolled glaucoma were treated with either the silicone or polypropylene Ahmed Glaucoma Valve implant. Success was defined according to 2 criteria: (1) intraocular pressure (IOP) of 6 mmHg or more or 21 mmHg or less, and (2) IOP reduction of at least 30% relative to preoperative values. Eyes requiring further glaucoma surgery, including cyclophotocoagulation, or showing loss of light perception were classified as failures. Average follow-up was 12.8 months (range, 6-30 months) for the silicone plate group and 14.5 months (range, 6-30 months) for the polypropylene plate group (P = 0.063). At the last follow-up examination, the mean IOP was 13.8+/-3.9 mmHg and 17.3+/-6.5 mmHg (P<0.0001) and the mean number of antiglaucoma medications was 1.9+/-1.3 and 2.1+/-1.4 (P = 0.48) in the silicone plate and polypropylene plate groups, respectively. The life-table success rates for the silicone plate and polypropylene plate groups were 94.2% and 83.2% at 12 months and 82.4% and 56.7% at 24 months by definition 1, respectively (P = 0.035). When an IOP reduction of at least 30% was used for success criterion (definition 2), probabilities of success were 89.5% and 71.7% at 12 months and 78.3% and 68.5% at 24 months in the silicone and the polypropylene plate groups, respectively (P = 0.012). Visual outcomes were comparable between the 2 groups. However, complications including Tenon's cyst were observed more frequently in the polypropylene plate than in the silicone plate group (P<0.05). The silicone Ahmed Glaucoma Valve (model FP7) showed improved IOP reduction compared with the polypropylene (model S2) implant. Differences observed in mean IOP, success rate, and complications suggest that plate material may influence clinical outcome.

0 comments Cited 38 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Indian J Ophthalmol

Journal ID (publisher-id): IJO

Title: Indian Journal of Ophthalmology

Publisher: Medknow Publications (India )

ISSN (Print): 0301-4738

ISSN (Electronic): 1998-3689

Publication date (Print): Sep-Oct 2009

Volume: 57

Issue: 5

Pages: 345-350

Affiliations

Department of Ophthalmology, Army Hospital (Research and Referral) Cantt -10, Delhi, India

Author notes

Correspondence to: Col JKS Parihar, Department of Ophthalmology, Army Hospital (Research and Referral) Cantt -10, Delhi, India. E-mail: jksparihar@ 123456gmail.com

Article

Publisher ID: IJO-57-345

DOI: 10.4103/0301-4738.55068

PMC ID: 2804121

PubMed ID: 19700871

SO-VID: 8ccb3622-a391-4fc0-8919-12c06406f342

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The efficacy of Ahmed glaucoma valve drainage devices in cases of adult refractory glaucoma in Indian eyes

Read this article at

Abstract

Aim:

Settings and Design:

Materials and Methods:

Results:

Conclusion:

Related collections

Karger: Ophthalmology

Most cited references 27

Follow-up of the original cohort with the Ahmed glaucoma valve implant.

Long-term follow-up of primary glaucoma surgery with Ahmed glaucoma valve implant versus trabeculectomy.

Comparison of polypropylene and silicone Ahmed Glaucoma Valves.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 355

Cited by 11

Most referenced authors 184