Long-term comparison of the outcomes of Ahmed Glaucoma Valve surgery between glaucoma surgeons and cornea trained surgeons.

Abstract

To compare the long-term outcomes obtained by glaucoma surgeons versus cornea trained surgeons performing Ahmed glaucoma valve (AGV) surgery. Of the total 376 patients (3month to 83year) conducted in this retrospective study, 130 patients with refractory glaucoma were evaluated who had been followed up for at least six months during ten years period. The primary outcome measure was the surgical success of AGV surgery that was categorized in two groups: (A5 ≤ IOP ≤ 21mmHg and at least 20% reduction in IOP without any glaucoma medications (complete success) and reduction by using one or more glaucoma medications (qualified success) (B) similar to previous criteria but the cutoff for higher IOP at 16mmHg without vision loss and the need for medication or re-surgery. Mean age of the patients was 32.99 ± 24.20years in the glaucoma surgeon group and 25.18 ± 24.33years in the cornea trained surgeons group (P = 0.07). The overall success of both methods at the end of four years were 66.7% and 41.7% for the group of glaucoma surgeons and cornea trained surgeons, respectively (p = 0.661). The cumulative success according to criterion A and B was 66.7% in the glaucoma surgeon group and 47.1% in the others surgeon group (P = 0.661). Repeated glaucoma surgery was required in 33.3% and 52.9% of the patients in the glaucoma surgeon and cornea trained surgeons groups, respectively (P = 0.661). Although there was a significant difference for IOP among various follow-up periods (p = 0.004), this difference was not significant between the two groups (p = 0.374).Visual Acuity did not have a signifiant difference between various follow-up periods and surgeons groups (p = 0.419 and P = 0. 690, respectively). There were comparable outcomes with regard to complications and success rates between glaucoma surgeons and cornea trained surgeons performing AGV surgery.