Comparison between Ahmed Glaucoma Valve Implantation in eyes with refractory glaucoma with and without Phacoemulsification

Abstract

<p>AIM: To compare the surgical outcomes of Ahmed glaucoma valve implantation (AGVI) alone and the AGVI combined with phacoemulsification (Phaco-AGVI) in primary open angle glaucoma (POAG) patients.<br>METHODS: A retrospective review was performed on POAG patients. A total of 43 eyes from 35 patients who were followed up for at least 2 years were collected. The primary outcome was the cumulative probability of success. Secondary outcome measures included IOP, number of glaucoma medications, and postoperative complications.<br>RESULTS: In total, 18 eyes underwent AGVI, and 25 eyes underwent Phaco-AGVI. There were no differences on the preoperative IOP (25.7 ± 10.7mmHg vs 26.3 ± 6.2mmHg, P = 0.808) and medications (2.1 ± 1.4 vs 1.6 ± 0.8, P = 0.141) between the AGVI and Phaco-AGVI groups. The qualified success rate in the Phaco-AGVI group were higher than those in the AGVI group at 2-year (96.6% vs 72.2 %, P = 0.013) follow-up. When the IOP < 18mmHg was considered successful, the qualified and complete success rates in the Phaco-AGVI group were higher than those in the AGVI group at 2-year follow-up (all p < 0.05). The postoperative IOP in the Phaco-AGVI group was significantly lower than that in the AGVI group only at the 3-month follow-up (P = 0.002). At the 3-month, 6-month and 2-year postoperative visits, patients in the Phaco-AGVI group used significantly fewer glaucoma medications than patients in the AGVI group. Eyes that underwent combined Phaco-AGVI experienced less encapsulated blebs than eyes that underwent AGVI (P = 0.009). More eyes occurred CCD in the Phaco-AGVI (48% vs 22.2%) although without statistically significance.<br>CONCLUSION: The surgical outcomes of Phaco-AGVI showed a higher cumulative probability of success and fewer postoperative complications than those of AGVI in this 2-year study.<br></p>