The Choice of Drainage Device in Complicated Glaucomas: Comparing Ahmed and Baerveldt Implants

Abstract

Background/Aim: Glaucoma is a chronic and progressive optic neuropathy which leads to deterioration of visual function. It is estimated to be the second leading cause of severe vision loss and blindness worldwide. Failure of antiglaucoma medication to sufficiently reduce intraocular pressure (IOP) and poor compliance with medication are indications for glaucoma surgery, for example using glaucoma drainage devices. Our aim was to compare the surgical outcomes following the implantation of Ahmed FP7 and Baerveldt 350 drainage devices. Patients and Methods: Five hundred and fiftytwo patients with primary or secondary glaucoma were enrolled in the study. All patients had a history of failed trabeculectomy or other intraocular surgery, and IOP ≥18 mm Hg. The implantation of Ahmed (266 patients) or Baerveldt (286 patients) devices was randomly performed in the patients, who were subsequently examined for a period of 5 years. Follow-up visits were scheduled 1 day;

Short Term Results of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma

“…Our IOP results at the final postoperative examination (13.84±2.95 mmHg) were similar to those of Moschos et al, [14] but lower than those reported by Yazgan et al [7] This may have been due to the longer postoperative follow-up duration in the Yazgan et al [7] study. Although the preoperative IOP values of our cases were much higher than those of Moschos et al, [14] a satisfactory postoperative success rate (complete success in 45.2% and qualified success in 54.8% for a total of 100% surgical success) was determined. However, the success rate may decrease with longer follow-up.…”

“…The mean follow-up duration was 32.3±20.7 months in that study of 48 refractory glaucoma cases. [7] The mean preoperative IOP level of our patients (40.84±8.27 mmHg) was much higher than that reported by Moschos et al [14] The reason may be that our study group included more complicated cases. Our IOP results at the final postoperative examination (13.84±2.95 mmHg) were similar to those of Moschos et al, [14] but lower than those reported by Yazgan et al [7] This may have been due to the longer postoperative follow-up duration in the Yazgan et al [7] study.…”

“…[7] The mean preoperative IOP level of our patients (40.84±8.27 mmHg) was much higher than that reported by Moschos et al [14] The reason may be that our study group included more complicated cases. Our IOP results at the final postoperative examination (13.84±2.95 mmHg) were similar to those of Moschos et al, [14] but lower than those reported by Yazgan et al [7] This may have been due to the longer postoperative follow-up duration in the Yazgan et al [7] study. Although the preoperative IOP values of our cases were much higher than those of Moschos et al, [14] a satisfactory postoperative success rate (complete success in 45.2% and qualified success in 54.8% for a total of 100% surgical success) was determined.…”

“…glaucoma using different success criteria. [11][12][13] Moschos et al [14] reported a mean IOP level of 28.3±9.3 mmHg in the preoperative period that decreased to 13.4±6.9 mmHg in the first postoperative year in a large group that had undergone AGV implantation for complicated glaucoma. A mean of 3.5±1.1 drugs were used preoperatively, which was reduced to 1.5±1.4 in the postoperative first year.…”

The ahmed versus Baerveldt study at King Khaled Eye Specialist Hospital: Three-year treatment outcomes

“…The IOP was postoperatively controlled using a lower number of medications in both the groups, although this number was significantly lower in patients with an Ahmed implant at the 3-year follow-up. [ 22 ] Another retrospective study performed by Tsai et al . noted a comparable result to our study, wherein during a follow-up of 12 months, the success rate (defined as 6 mmHg ≤ IOP ≤ 21 mmHg without additional glaucoma surgery or devastating complication) in the Ahmed group (48 patients) was higher than in the Baerveldt one (70 patients).…”