Long-term clinical outcomes of Ahmed valve implantation in patients with refractory glaucoma

Lee, Chang Kyu; Tak, Kyoung; Hong, Young Jae; Kim, Chan Yun

doi:10.1371/journal.pone.0187533

Cited by 42 publications

(43 citation statements)

References 30 publications

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“…Previous studies demonstrating the success rates of initial AGVs yielded similar results. eir cumulative success rates ranged from 75.0% to 87.0% at one year, 60.6% to 75.0% at two years, and 54.0% to 66.0% at three years [2,[23][24][25][26][27]. Despite being a second AGV implantation, our success rates are comparable to that of initial AGVs in current literature.…”

Section: Discussionsupporting

confidence: 54%

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Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Ong

Aquino

Chew

et al. 2020

Journal of Ophthalmology

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Introduction. When the initial glaucoma tube shunt fails in eyes with refractory glaucoma, one option is implantation of an additional Ahmed glaucoma valve (AGV) to control intraocular pressure (IOP). We aim to evaluate the outcomes of a second AGV in Asian glaucoma. Material and Methods. This is a retrospective interventional study, consisting of 21 eyes belonging to 20 patients which underwent a second FP7 AGV. Data collected included demographic characteristics, best corrected visual acuity, IOP, and number of medications. Both intraoperative and postoperative complications or interventions were recorded. The primary outcome measurement was success rate: complete success (IOP ≥5 mmHg and ≤21 mmHg without IOP-lowering medications) and qualified success (IOP ≥5 mmHg and ≤21 mmHg with IOP-lowering medications). Failure was defined as IOP ≥5 mmHg and ≤21 mmHg, reoperations for IOP-related indications, removal of second AGV implant, or loss of light perception. Postoperative complications were included as secondary outcomes. Results. The cumulative failure rates were 9.5%, 20.0%, 32.5%, and 46.0% at six months, one year, two years, and three years of follow-up. At final follow-up, complete success and qualified success rates were 23.8% and 33.3%, respectively; mean IOP and number of medications decreased by 5.6 mmHg (23.9%) and 1.7 mmHg (54.8%), respectively, from preoperative baseline (P<0.01). More common postoperative complications included hypertensive phase (38.1%), corneal decompensation (23.8%), and tube exposure (14.3%). Conclusion. An additional AGV implant had good short and modest long-term effectiveness in reducing IOP following a failed glaucoma tube shunt in Asian eyes, with the mentioned common postoperative complications to be actively monitored and managed.

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Section: Discussionsupporting

confidence: 54%

“…Glaucoma tube shunts are effective in lowering intraocular pressure (IOP) for eyes with refractory glaucoma [1][2][3][4]. One of the most common implant is Ahmed glaucoma valve (AGV; New World Medical, Inc., CA), a glaucoma drainage device (GDD) that drains aqueous humour into a 184 mm 2 plate close to the equator of the eye.…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Ong

Aquino

Chew

et al. 2020

Journal of Ophthalmology

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“…Almost all types of glaucoma may evolve to refractory glaucoma, and the state of the conjunctiva together with a patient’s systemic health state may precipitate this condition. For these reasons, glaucoma filtration devices such as the Ahmed Glaucoma Valve (New World Medical, Rancho Cucamonga, CA, USA), Baerveldt (Advanced Medical Optics, Inc., Santa Ana, CA, USA), or Molteno (IOP, Inc., Costa Mesa, CA, USA, and Molteno Ophthalmic Limited, Dunedin, New Zealand) valves have been demonstrated to be safe and effective in lowering IOP and are therefore widely used in complex cases such as secondary and refractory glaucoma [ 4 , 5 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Second Ahmed Valve Implant in Refractory Glaucoma

Posarelli

Toro

Ręjdak

et al. 2020

JCM

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Background: Refractory glaucoma still represents a challenge for ophthalmologists to manage intraocular pressure. The present study aimed to evaluate long term efficacy and safety of a second Ahmed valve implantation after the failure of a first implant in patients with refractory glaucoma and elevated intraocular pressure (IOP). Methods: Retrospective, multicenter non-comparative case series. Twenty-eight patients were retrospectively recruited between January 2011 and December 2017. Demographic data, glaucoma type, visual acuity, intraocular pressure, medical therapy, and complications were registered. Three criteria of success were established: Type 1 surgical success: IOP ≤ 15 mmHg and a reduction of IOP ≥ 40% from baseline; Type 2 surgical success: IOP ≤ 18 mmHg and a reduction of IOP ≥ 30% from baseline; and Type 3 surgical success: IOP ≤ 21 mmHg and a reduction of IOP ≥ 20% from baseline. Surgical failure has been established as IOP less than 5 mmHg or over 21 mmHg and less than a 20% reduction of IOP from baseline despite medications in two consecutive visits, light perception loss referable to glaucoma, and the necessity for further glaucoma surgery. Failure was observed in six (21%) patients. (3) Results: Mean IOP and mean glaucoma medication number significantly reduced from baseline after the second implantation, and the surgical success rate at 72 months ranged from 10% to 78% based on the different criteria of success. Failure was observed in six (21%) patients. Conclusions: This study confirmed the safety and efficacy of a second Ahmed valve implantation in patients with refractory glaucoma and elevated IOP at baseline.

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“…Однако этот же механизм является самым узким местом дренажной системы, что повышает риск закупорки дренажа сгустками крови и фибрином [12][13][14][15]. По данным разных авторов, клапанная система Ahmed эффективна в 35-60 % случаев [2,16,17].…”

Section: Ophthalmology In Russia 2019;16(1s):123-126 актуальностьunclassified

Valved and Non-Valved Drainage Systems in the Surgical Treatment of Refractory Glaucoma

Карлова

Радайкина

2019

Oftalʹmologiâ

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Purpose: to compare the efficacy and safety of Ahmed and Molteno-3 drainage devices implantation in the surgical treatment of refractory glaucoma. Patients and methods. Two groups of refractory glaucoma patients underwent surgery. In the first group (48 patients, 48 eyes) drainage device Molteno-3 with a site size of 175 mm2 was implanted. The average IOP in the group before surgery was 31.9 ± 7.7 mm Hg. The average number of glaucoma medications was 3.3 ± 0,44. In the second group (51 patients, 51 eyes) implantation of Ahmed Valve FP7 model was performed. The average level of IOP in the group before surgery was 34.7 ± 8.07 mm Hg. The average number of glaucoma medications was 3.08 ± 0.4. Results. In the first group the average intraocular pressure level 1 month post-op was 14.6 ± 6.1 mm Hg, 3 months post-op 18.8 ± 5.2 mm Hg, 6 months post-op 16.5 ± 4.7 mm Hg. IOP сompensation (≤ 21 mm Hg) in 6 months was achieved in 91.6 % of cases and in 1 year in 100 % of cases. The total success was achieved only in 8.3 % of patients. However, the number of glaucoma medications was reduced to 1.6 ± 0.8. In the second group the average IOP level 1 month post-op was 21.25 ± 7.3 mm Hg, 3 months post-op 17.9 ± 5.3 mm Hg, 6 months post-op 15.7 ± 4.1 mm Hg. IOP сompensation in 6 months was achieved in 82.4 % of cases and in 1 year in 86.3 %. In the second group complete success was achieved in 19.6 % of patients. The number of glaucoma medications was 1.4 ± 1.1. In the first group complications were revealed in 22.9 % of cases (11 patients). Ciliochoroid detachment was revealed in 9 patients (18,8 %) and hyphema in 2 patients (4,2 %). In the second group complications were revealed in 19.6 % of cases (10 patients). Сiliochoroid detachment was revealed in 4 patients (7.8 %), diplopia in 5 patients (9.8 %), hyphema was detected in one case (1.9 %). In the first group IOP compensation (≤21 mm Hg) was achieved after 6 months in 91.6 % of cases and after 1 year in 100 % of cases. The complete success was achieved in only 8.3 %. In the second group, IOP compensation in 6 months was achieved in 82.4 % of cases and 86.3 % — in 1 year. In the second group, complete success was achieved in 19.6 % patients. There was no significant difference in complications between two groups. Conclusion. High level of safety and effectiveness of refractory glaucoma surgical treatment with implantation of Molteno-3 and Ahmed drains was confirmed.

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Long-term clinical outcomes of Ahmed valve implantation in patients with refractory glaucoma

Cited by 42 publications

References 30 publications

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Safety and Efficacy of Second Ahmed Valve Implant in Refractory Glaucoma

Valved and Non-Valved Drainage Systems in the Surgical Treatment of Refractory Glaucoma

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