Safety and efficacy of Ahmed glaucoma valve implantation in refractory glaucomas in Northern Indian eyes

Abstract

AbstractPurposeTo evaluate the safety and efficacy of Ahmed glaucoma valve (AGV) implantation in refractory glaucoma in Northern Indian eyes.BackgroundThe success rate of trabeculectomy remains low in cases of refractory glaucoma even with the use of antifibrotics. Glaucoma drainage devices have proven to be more efficacious in reducing intraocular pressure (IOP) in these glaucomas.MethodsRetrospective records of 55 consecutive patients who underwent AGV implantation at Dr. Shroff’s Charity Eye Hospital, New Delhi, India from January 2003 to December 2012 were reviewed. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications, number of prior incisional surgeries, visual acuity and IOP on medical treatment. Postoperative data included visual acuity and IOP on day one, 1week, 1month, 3months, 6months, 1year and yearly thereafter, number of anti-glaucoma medications, any complication or additional surgical intervention required. Success was defined as IOP >5 and <22mmHg with or without treatment.ResultsMean IOP decreased from 39.71±8.99 pre-operatively to 17.52±5.72mmHg at last follow-up (p<0.001) and number of medications reduced from 3.27±0.84 to 1.25±0.88 (p<0.001). Visual acuity remained within one Snellen line or improved at last follow-up in 47 cases (85.4%). The cumulative probability of success was 85.45% at 1year and 79.63% at 3years. The incidence of post-operative complications was 25.45%.ConclusionAGV implantation has proven to be safe and is effective in controlling IOP in refractory glaucoma in Northern Indian eyes