Ahmed Glaucoma Valve Implantation in African American and White Patients

Ishida, Kyoko

doi:10.1001/archopht.124.6.800

Cited by 43 publications

(26 citation statements)

References 33 publications

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“…The authors found a higher risk of surgical failure in African-Americans (91 and 75% of success at 1 and 3 years respectively) compared with the group of Caucasians (100 and 96% of success at 1 and 3 years respectively). 37 In the present study, considering both success criteria, the multivariate analysis showed that Caucasian race had a lower risk of implant failure.…”

Section: Discussionsupporting

confidence: 46%

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Schimiti¹,

Abe

Tavares

et al. 2016

Journal of Current Glaucoma Practice

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AimTo evaluate the results of Ahmed glaucoma valve (AGV) in eyes with a failed trabeculectomy.Materials and methodsThis retrospective study evaluated 61 eyes with a failed trabeculectomy that underwent implantation of an AGV due to uncontrolled intraocular pressure (IOP) on maximal medical therapy. Success was defined as IOP ≤ 21 mm Hg (criterion 1) or 20% reduction in IOP (criterion 2) with or without antiglaucoma medications. Persistent hypotony, loss of light perception, and reoperation for IOP control were defined as failure.ResultsMean preoperative IOP and mean lOPs at 6, 12, and 24 months were 21.93 ± 6.32 mm Hg (n = 61), 14.15 ± 4.33 mm Hg (n = 59), 13.21 ± 4.44 mm Hg (n = 56), and 13.60 ± 3.27 mm Hg (n = 25) respectively. Mean number of antiglaucoma medications preoperatively and at 6, 12, and 24 months was 3.95 ± 0.85, 2.19 ± 1.38, 2.48 ± 1.44, and 2.40 ± 1.32 respectively. The reductions in the number of medications and IOP measurements were statistically significant at all time intervals (p < 0.001, Wilcoxon signed rank test). According to criterion 1, the Kaplan-Meier survival curve disclosed success rates of 75% at 12 and 24 months. According to criterion 2, the success rates were 57% at 12 months and 55% at 24 months. The most frequent complications were hypertensive phase (18%) and shallow anterior chamber (16.4%).ConclusionThe AGV may effectively reduce IOP in eyes that had a failed trabeculectomy.Clinical significanceThe AGV is an alternative in eyes with a failed trabeculectomy.How to cite this articleSchimiti RB, Abe RY, Tavares CM, Vasconcellos JPC, Costa VP. Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy. J Curr Glaucoma Pract 2016;10(3):97-103.

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Section: Discussionsupporting

confidence: 46%

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Schimiti¹,

Abe

Tavares

et al. 2016

Journal of Current Glaucoma Practice

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“…According to the multivariate analysis, African American descent was significantly associated with risk of failure. This finding is in agreement with a previous study from Ishida and Netland, where 86 eyes from 43 African Americans and 43 Caucasian patients were followed for an average of 2.5 years after AGV implantation [14]. In their study, two different definitions for success were adopted.…”

Section: Discussionsupporting

confidence: 90%

“…Cumulative survival rates were calculated using Kaplan-Meier survival analysis. We included variables previously listed as risk factors according to [10, 13, 14]. Since both eyes of some patients were evaluated, univariate and multivariate analyses were performed with generalized estimating equations with the exponentiation results presented in Odds Ratios.…”

Section: Methodsmentioning

confidence: 99%

Ahmed Glaucoma Valve Implantation for Refractory Glaucoma in a Tertiary Hospital in Brazil

Abe

Tavares

Schimiti

et al. 2015

Journal of Ophthalmology

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Purpose. To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) implantation in patients with refractory glaucoma in a tertiary hospital in Brazil. Methods. Retrospective case series of patients who underwent AGV implantation. Primary outcome was to assess the rate of failure, which was defined as intraocular pressure (IOP) in two consecutive visits greater than 18 or lower than 5 mmHg (criterion 1) or IOP greater than 15 or lower than 5 mmHg (criterion 2). The secondary outcome was to investigate risk factors for failure. Results. 112 eyes from 108 patients underwent AGV implantation between 2000 and 2012. Mean follow-up time was 2.54 (±1.52) years. Kaplan-Meier survival analysis showed cumulative probabilities of success of 80.3%, 68.2%, and 47.3% at 1, 3, and 5 years using 18 mmHg as endpoint. When adopting 15 mmHg as endpoint, cumulative success rates were 80.3%, 60.7%, and 27.3% at 1, 3, and 5 years, respectively. Multivariate analysis with generalized estimating equations revealed that African American ancestry and early hypertensive phase were risk factors for failure (P = 0.001 and P = 0.002, resp.). Conclusion. A success rate of approximately 50% was obtained 5 years after the implantation of an AGV. African American ancestry and early hypertensive phase were associated with increased risk of failure.

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“…However, nonwhite ethnicity is a well-known risk factor for failure of glaucoma surgery. 28 Cyclophotocoagulation is known to cause low-grade inflammation in the anterior chamber likely secondary to blood-aqueous barrier breakdown. 29 This may cause upregulation of the inflammatory cascade and hence more intense fibrosis.…”

Section: Discussionmentioning

confidence: 99%