The Ahmed Glaucoma Valve in refractory glaucoma: experiences in Indian eyes.

Abstract

To evaluate the efficacy of the Ahmed Glaucoma Valve implant in refractory glaucomas in Indian eyes. A retrospective review was conducted on the charts of 122 eyes of 122 patients with refractory glaucoma treated with Ahmed Glaucoma Valve implant placement at Guru Nanak Eye Centre, New Delhi between January 1996 and December 1999. The main outcome measure was success at the last follow-up. Success was defined as an intraocular pressure (IOP) of 22 mmHg or less and 5 mmHg or more and at least a 30% reduction in IOP without visually devastating complications or additional glaucoma surgery. The mean postoperative IOP (17.29+/-3.79 mmHg) was significantly (P<0.001) lower than the mean preoperative IOP (31.47+/-7.86 mmHg) at last follow up (mean 12.51+/-8.37 months; range 3-24 months). The cumulative probability of success by Kaplan-Meier analysis was 85.95% at 12 months and 82.83% at 24 months. The mean number of postoperative antiglaucoma medications (0.75+/-0.80) was also significantly lower (P<0.001) than the mean preoperative number of antiglaucoma medications (2.83+0.72). The most common complication was corneal-tube contact, which occurred in five (4.10%) eyes. Retinal detachment occurred postoperatively in one eye with the clinical diagnosis of neovascular glaucoma secondary to Eale's disease. Two patients had tube extrusion requiring repositioning and reinforcement with scleral patch graft. Ahmed Glaucoma Valve implantation is an effective and relatively safe therapy for the treatment of refractory glaucoma in Indians.