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Br J Ophthalmol 2009;93:1504-1509 doi:10.1136/bjo.2008.150870
  • Original Article
  • Clinical science

Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma

  1. D H Tran1,
  2. C Souza1,2,
  3. M J Ang1,
  4. J Loman1,
  5. S K Law1,
  6. A L Coleman1,
  7. J Caprioli1
  1. 1
    Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
  2. 2
    Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
  1. Correspondence to Dr J Caprioli, Glaucoma Division, Jules Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA 90095, USA; caprioli{at}jsei.ucla.edu
  • Accepted 22 February 2009
  • Published Online First 1 July 2009

Abstract

Aim: To compare the long-term intraocular pressure (IOP) outcomes of Ahmed Glaucoma Valve (AGV) implantation to trabeculectomy with mitomycin C (MMC) in open-angle glaucoma (OAG).

Methods: 78 OAG patients who underwent AGV implantation were matched with respect to age, preoperative surgery, preoperative IOP and preoperative medicines to 88 OAG patients who underwent trabeculectomy with MMC with a minimum of 3 years’ follow-up. The cumulative probability of success between the two groups with different criteria was analysed: (1) an IOP≤21 mm Hg and a reduction of IOP≥15% from baseline; and (2) an IOP≤18 mm Hg and a reduction of IOP≥20% from baseline. No loss of light perception, no additional glaucoma surgery and no hypotony were also required.

Results: The 5-year cumulative probability of success was not statistically significant between eyes that had an AGV or trabeculectomy with MMC when success was defined as criteria A (p = 0.094). However, when success was defined according to criteria B, eyes undergoing trabeculectomy with MMC had a higher rate of success (p = 0.024).

Conclusions: Trabeculectomy with MMC has a significantly higher 5-year cumulative probability of success compared with AGV implants when greater reduction IOP is necessary.

Footnotes

  • Funding Supported in part by an unrestricted grant from Research to Prevent Blindness. The authors also received support from D May II, E Kelton and L Kelton.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval Ethics approval was provided by the Human Subject Protection Committee at the University of California, Los Angeles.

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