Surgical outcomes of the Aurolab aqueous drainage implant (AADI) versus the Ahmed glaucoma valve for refractory paediatric glaucoma in Middle Eastern children

Abstract

ObjectiveThe Aurolab aqueous drainage implant (AADI) has the potential advantages of less encapsulation and greater cost-effectiveness than the Ahmed glaucoma valve (AGV). The aim of this study was to compare the surgical success and outcomes of the AADI compared to the AGV in Middle-Eastern children.MethodsA comparative retrospective study of consecutive paediatric patients in a tertiary eye hospital was undertaken. Data collected included demographics, type of glaucoma, intraocular pressure (IOP), number of anti-glaucoma medications (AGMs) and any subsequent complications or further surgeries.AnalysisThe mean IOP, number of AGMs, surgical success and number of reoperations was compared for the two groups. Surgical success at each visit was defined as IOP of ≥6 mm Hg and ≤21 mm Hg or if the reduction of IOP was ≥20% reduced from baseline.ResultsA total of 126 tube surgeries (56 eyes in AADI and 70 eyes in AGV) were performed in patients aged ≤18 years from 2014 to 2019. No difference was observed in the mean IOP between the two groups except at the first month post-operative visit. After six months, the AADI group had a consistently significant lower mean number of AGMs. At last follow-up, 21 (37.5%) eyes in the AADI group were glaucoma medication-free vs 15 (21.4%) eyes in the AGV group (pp=0.047). Kaplan-Meier analysis showed equivalent cumulative probability of success at two years of 69.9% [(45.9%–84.9%)] for AADI vs 66.8% [(53.4%–77.1%])) for the AGV, respectively. Twenty-four eyes in the AGV group needed one or more subsequent surgeries, whereas 13 eyes needed one or more surgery in the AADI group.ConclusionsThis study shows an acceptable safety profile for the AADI in children, with a rate of failure that is comparable to the AGV, but less need for glaucoma re-operation or glaucoma medication in the first post-postoperative year.

Surgical Outcomes of Glaucoma Drainage Device Implantation in Refractory Glaucoma Patients in Thailand

“…The efficacy and safety of GDD implantation varied along with different types of GDD model and various underlying glaucoma etiologies. 6,7,11,12 The cumulative probability of complete and qualified success during five years of follow-up from the Tube Versus Trabeculectomy (TVT) study using nonvalved GDD and Baerveldt® Glaucoma Implants (BGI) was 70.2%, similar to 76.5% from our nonvalved GDD result in the primary glaucoma group. The etiologies of glaucoma participants in the TVT were similar to our primary glaucoma group including POAG, PACG and JOAG.…”

“…The efficacy and safety of GDD implantation varied along with different types of GDD model and various underlying glaucoma etiologies. 6 , 7 , 11 , 12 …”

“… 18 In contrast, the result from Khan et al showed an equivalent cumulative probability of success at the two-year follow-up between AADI and the AGV in children of 69.9% (95%CI: 45.9%, 84.9%) for the AADI vs 66.8% (95%CI: 53.4%, 77.1%) for the AGV, respectively. 12 Following from our study which included a small number of children, comparison with those studies were limited.…”

Comparison of Aurolab Aqueous Drainage Implant with Ahmed Glaucoma Valve for refractory glaucoma: a meta-analysis

“…Ultimately, six studies published between 2018 and 2021 were included in the present meta-analysis. [16][17][18][19][20][21] The trial selection process is presented in Fig. 1.…”

Commentary: Retinal detachment in eyes treated with Aurolab aqueous drainage implant for refractory glaucoma - Incidence and outcomes

“…[ 6 ] Khan et al . [ 7 ] reported the incidence of RRD after AADI and AGV implantation to be 5.4% and 4.3%, respectively. The present authors analyzed the outcomes of 10 cases of RRD/1158 (0.86%) cases after AADI implantation.…”