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Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year
  1. Vanita Pathak Ray1,
  2. Divya P Rao2
  1. 1 Department of Glaucoma, Centre for Sight, Banjara Hills, Hyderabad, India
  2. 2 L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
  1. Correspondence to Dr Vanita Pathak Ray, Department of Glaucoma, Centre for Sight, Banjara Hills, Hyderabad 500034, India; vpathakray{at}gmail.com

Abstract

Background A new low-cost, indigenously manufactured, non-valved glaucoma drainage device (GDD) has been introduced and its design is based on the Baerveldt Glaucoma Device. We aim to demonstrate the efficacy and safety of this GDD (Aurolab aqueous drainage implant, AADI) vis-à-vis the valved device, Ahmed glaucoma valve (AGV), in the management of refractory glaucomas.

Design Retrospective, comparative, interventional.

Participants Case review of consecutive patients who underwent GDD surgery by a single fellowship-trained surgeon at a Tertiary Centre between January 2014 and November 2016.

Primary outcome measure Intraocular pressure (IOP).

Secondary Antiglaucoma medication (AGM), LogMAR best-corrected visual acuity (BCVA), complications.

Results A total of 88 eyes of 83 patients were included; 36 eyes received AGV and 52 AADI. Preoperative parameters were similar between groups. Median follow-up was 13 and 12 months for AADI and AGV, respectively. Overall success rate was higher in AADI (92.3%) vs AGV (80.5%) (p<0.001). The median IOP in mm Hg (Quartiles; IQR) (AADI 14 (10,15;5) vs AGV 16 (14,20;6)) and AGM (AADI: 0 (0,1;1) vs AGV 2 (1,2.75;1.75)) was significantly lower in the AADI group at last follow-up (p<0.001). LogMAR BCVA improved in both groups; complication rates (AADI 44.2% vs AGV 52.7%) were comparable (p=0.59).

Conclusions Both procedures were effective in reduction of IOP and need for AGM. Nevertheless, overall success rate was higher in the AADI group and IOP and number of AGM required was significantly lower in the AADI group; this affordable GDD could have a tremendous impact in the management of refractory glaucomas in low-income to middle-income countries.

  • glaucoma drainage device
  • GDD
  • valved GDD
  • AADI
  • Ahmed glaucoma valve
  • non-valved GDD
  • Aurolab Aqueous Drainage Implant

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Footnotes

  • Contributors VPR: concept, data acquisition, data analysis and interpretation, critical review of manuscript, final approval of manuscript. DPR: data acquisition, data analysis and interpretation, drafting and critical review of manuscript, final approval of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board/Ethics Committee at L V Prasad Eye Institute, Hyderabad, India.

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

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