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Ahmed Glaucoma Valves in refractory glaucoma – a seven year audit.
  1. Peter K Wishart*,
  2. Anshoo Choudhary,
  3. David Wong
  1. 1 St. Paul’s Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
  1. Correspondence to: Peter K Wishart, St Paul's Eye Unit, Royal Liverpool University Hospital, Royal Liverpool University Hospital, Prescot St,, Liverpool, L7 8XP, United Kingdom; peter.wishart{at}rlbuht.nhs.uk

Abstract

Purpose: To present the long-term results of Ahmed Glaucoma Valve (AGV) implantation.

Methods: Consecutive case-series of 94 eyes with AGV implantation over 7 years. Temporary tube ligation with C3F8 gas fill was used in high-risk eyes (Group G&L) and compared to standard implantation in both phakic (Group-A) and pseudophakic/aphakic eyes (Group-B). Success was intraocular pressure (IOP) ≥6 mm Hg and ≤ 21 mmHg and/or IOP reduction ≥20%.

Results: Average follow-up was 28.9 ± 20.3 months. Mean pre-operative IOP changed from 30.8 ± 8.2 to 19.7 ± 7.6 mm Hg and mean pre-operative medications from 3.3 ± 1.2 to 1.2 ± 1.1 at final visit. Cumulative probability of survival at 1 and 4 years was 89.1% and 72.9%. There was no statistically significant difference in success between the 3 groups, but complications due to post-operative hypotony (6 eyes) only occurred in Group B. Other complications were corneal decompensation (3 eyes), tube erosion (6 eyes) and aqueous misdirection (4 eyes).

Conclusions: AGV implantation offered good long-term IOP control with a success rate of 78.7%. We recommend C3F8 gas fill and temporary tube ligation in eyes at high-risk of post-operative hypotony and use of donor sclera or human pericardial patch to prevent tube erosion.

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