Surgical Outcomes of a Second Ahmed Glaucoma Valve Implant for the Treatment of Refractory Glaucoma. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: Becerril-Cazadero, Roxana; Seibold, Leonard K.; Turati-Acosta, Mauricio; Jiménez-Roman, Jesus; Fabre-Miranda, Karina; Han, Ying; Lazcano-Gomez, Gabriel
• Is Part Of: Journal of glaucoma. Volume 29:Issue 10(2020)
• Publication Date: 2020-10
• Subjects: Ahmed glaucoma valve -- refractory glaucoma -- intraocular pressure; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000001585
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Précis: In this article, the authors concluded that an additional Ahmed glaucoma valve (AGV) implantation after the failure of an initial AGV, even with the addition of glaucoma medications, maybe a good surgical treatment option for refractory glaucoma. Purpose: To evaluate the surgical outcomes of a second AGV implant in Hispanic patients with refractory glaucoma. Materials and Methods: The medical records of patients who underwent a second AGV implant were reviewed retrospectively. Clinical outcome measures including intraocular pressure (IOP), visual acuity, and glaucoma medication use were collected from the preoperative visit and all follow-up visits up to 18 months after surgery. Failure was defined as one of the following: loss of light perception, sustained IOP >21 or <6 mm Hg, an IOP reduction of <20% from baseline, need for additional glaucoma surgery, including needling revision with subconjunctival adjuvant therapy, or valve extrusion. Results: A total of 48 patients were included. In all cases, an S-2 model was implanted in the superonasal quadrant. Mean preoperative IOP was 24.3±7.9 mm Hg and was significantly reduced to 13.9±4.8 at 6 months ( P <0.05), 15.4±7.2 at 12 months ( P <0.05), and 12.9±2.0 at 18 months ( P <0.05). Mean glaucoma medications were reduced from 2.8±1.1 preoperatively to 1.9±1.2 at 6 months ( P <0.05), 2.4±1.2 at 12 months, and 2.2±1.1 at 18 months; however, the difference was no longer statistically significant after 6 months, and the success rate was 60% at the mean for survival time of 15 months (13.7 to 16.5). Conclusion: The findings of this study demonstrate that a second AGV can achieve a significant reduction in IOP for up to 18 months postoperatively. Abstract : Supplemental Digital Content is available in the text.