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Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique

Received: 16 April 2022    Accepted: 3 May 2022    Published: 12 May 2022
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Abstract

Purpose: To investigate intraocular pressure (IOP) control, visual acuity, and complications at 1 year after Ahmed Glaucoma Valve (AGV) implantation. Methods: This was a retrospective, observational study of 35 AGV implanted patients who were followed up to 1-year post-surgery. The AGV implantation was performed at a tertiary healthcare facility in India. The IOP control, visual acuity status, and safety after AGV implantation with a specific modification of surgical technique were evaluated. Results: The study included 35 patients who underwent AGV implantation. The IOP reduced to near-normal levels post-surgery with immediate benefit being seen at Month 1, and the benefit was sustained till Month 12 as measured by the mean IOP. At all-time points post-surgery, patients had stable visual acuity. Post-surgery, the use of medication decreased over time during the study in all patients. There were no new or unexpected complications post-surgery. In most patients, AGV implantation was well-tolerated. Conclusions: AGV implantation with modified surgical technique (tube is not anchored to the sclera and partial thickness scleral flap covers the tube) works very well at intermediate term as regard to IOP control and visual acuity and it is an effective way of treating the patients with refractory glaucoma.

Published in International Journal of Ophthalmology & Visual Science (Volume 7, Issue 2)
DOI 10.11648/j.ijovs.20220702.14
Page(s) 65-72
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Refractory Glaucoma, AGV, Trabeculectomy, Intraocular Pressure, Visual Acuity

References
[1] ANSI Standard for Implantable Glaucoma Devices: A Framework for Clinical Evaluation. https://www.fda.gov/media/88139/download. Last accessed on 27 August 2020.
[2] European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition Chapter 3: Treatment principles and options Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 3 Treatment principles and options. Br J Ophthalmol. 2017; 101: 130–95.
[3] Zarei R, Amini H, Daneshvar R, Nabi FN, Moghimi S, Fakhraee G, et al. Long-term outcomes of ahmed glaucoma valve implantation in refractory glaucoma at Farabi Eye Hospital, Tehran, Iran. Middle East Afr J Ophthalmol. 2016; 23: 104–9.
[4] Mokbel TH, El Hefney EM, Hagras SM, Badawi AE, Kasem MA, Al Nagdy AA, et al. Launching a paradigm for first and redo-surgery in primary congenital glaucoma: institutional experience. Int J Ophthalmol. 2019; 12: 226–34.
[5] Riva I, Roberti G, Katsanos A, Oddone F, Quaranta L. A Review of the Ahmed glaucoma valve implant and comparison with other surgical operations. Adv Ther. 2017; 34: 834–47.
[6] Barton K, Feuer WJ, Budenz DL, Schiffman J, Costa VP, Godfrey DG, et al. Three-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2014; 121: 1547–57.
[7] Budenz DL, Barton K, Gedde SJ, Feuer WJ, Schiffman J, Costa VP, et al. Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2015; 122: 308–16.
[8] Elbaklish KH, Saleh SM, Gomaa WA. Baerveldt glaucoma implant versus ahmed glaucoma implant in a one-year follow up, Comparative Study. Clin Ophthalmol. 2020; 14: 29–39.
[9] Xie Z, Liu H, Du M, Zhu M, Tighe S, Chen X, et al. Efficacy of Ahmed glaucoma valve implantation on neovascular glaucoma. Int J Med Sci. 2019; 16: 1371–6.
[10] Ong SC, Aquino MC, Chew P, Koh V. Surgical outcomes of a second Ahmed glaucoma valve implantation in Asian eyes with refractory glaucoma. J Ophthalmol. 2020; 2020: 8741301.
[11] Gebremichael BG, Mohamed A, Chaurasia S, Senthil S. Outcomes of Ahmed glaucoma drainage implant in eyes with glaucoma secondary to iridocorneal endothelial syndrome. J Glaucoma. 2020; 29: 567-71.
[12] Ramyashri S, Raj N, Pradhan A, Ali MH, Rao A. Outcomes of Ahmed glaucoma valve FP8 versus FP7 in adult secondary glaucoma. Int Ophthalmol. 2020; 40: 1359-66.
[13] Christakis PG, Tsai JC, Kalenak JW, Zurakowski D, Cantor LB, Kammer JA, et al. The ahmed versus baerveldt study: three-year treatment outcomes. Ophthalmology. 2013; 120: 2232–40.
[14] Pakravan M, Esfandiari H, Yazdani S, Doozandeh A, Dastborhan Z, Gerami E, et al. Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma. Eur J Ophthalmol. 2019; 29: 44–51.
[15] Lai JS, Poon AS, Chua JK, Tham CC, Leung AT, Lam DS. Efficacy and safety of Ahmed glaucoma valve implant in Chinese eyes with complicated glaucoma. Br J Ophthalmol. 2000: 84: 718–21.
[16] Parihar JK, Vats DP, Maggon R, Mathur V, Singh A, Mishra SK. The efficacy of Ahmed Glaucoma Valve drainage devices in cases of adult refractory glaucoma in Indian eyes. Indian J Ophthalmol. 2009; 57: 345–50.
[17] Dubey S, Sharma V, Agrawal A, Chauhan L, Douglas G. Safety and efficacy of Ahmed glaucoma valve implantation in refractory glaucomas in Northern Indian eyes. Saudi J Ophthalmol. 2015; 29: 103–8.
[18] Choudhari NS, George R, Shantha B, Neog A, Tripathi S, Srinivasan B, et al. Ahmed Glaucoma valve in eyes with pre-existing episcleral encircling element. Indian J Ophthalmol. 2014; 62: 570–4.
[19] Shah MR, Khandekar RB, Zutshi R, Mahrooqui R. Short term outcome of Ahmed Glaucoma Valve implantation in management of refractory glaucoma in a tertiary hospital in Oman. Oman J Ophthalmol. 2013; 6: 27–32.
[20] García-Delpech S, Sanz-Marco E, Martinez-Castillo S, López-Prats MJ, Udaondo P, Salom D, et al. Ahmed valve, suture-less implantation: A new approach to an easier technique. J Glaucoma. 2013; 22: 750–6.
[21] Coleman A, Hill R, Wilson R, Choplin N, Neumannm R, Bacharach J, et al. Initial clinical experience with the Ahmed Glaucoma Valve implant. Am J Opthalmol. 1995; 120: 23–31.
[22] Elhefney E, Mokbel T, Abou Samra W, Kishk H, Mohsen T, El-Kannishy A. Long-term results of Ahmed glaucoma valve implantation in Egyptian population. Int J Ophthalmol. 2018; 11: 416–21.
[23] Lee CK, Ma KT, Hong YJ, Kim CY. Long-term clinical outcomes of Ahmed valve implantation in patients with refractory glaucoma. PLoS One. 2017; 12: e0187533.
[24] Lee HY, Park JS, Choy YJ, Lee HJ. Surgical outcomes of different Ahmed Glaucoma Valve implantation methods between scleral graft and scleral flap. Korean J Ophthalmol. 2011; 25: 317–22.
[25] Gedar Totuk OM, Kabadayi K, Colakoglu A, Ekizoglu N, Aykan U. A novel surgical technique for prevention of Ahmed glaucoma valve tube exposure: long scleral flap augmented with Tenon advancement and duplication. BMC Ophthalmol 2018; 18: 226.
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    Tanuja Kate, Rajiv Choudhary, Divya Patel, Urvija Choudhary. (2022). Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique. International Journal of Ophthalmology & Visual Science, 7(2), 65-72. https://doi.org/10.11648/j.ijovs.20220702.14

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    ACS Style

    Tanuja Kate; Rajiv Choudhary; Divya Patel; Urvija Choudhary. Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique. Int. J. Ophthalmol. Vis. Sci. 2022, 7(2), 65-72. doi: 10.11648/j.ijovs.20220702.14

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    AMA Style

    Tanuja Kate, Rajiv Choudhary, Divya Patel, Urvija Choudhary. Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique. Int J Ophthalmol Vis Sci. 2022;7(2):65-72. doi: 10.11648/j.ijovs.20220702.14

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  • @article{10.11648/j.ijovs.20220702.14,
      author = {Tanuja Kate and Rajiv Choudhary and Divya Patel and Urvija Choudhary},
      title = {Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {7},
      number = {2},
      pages = {65-72},
      doi = {10.11648/j.ijovs.20220702.14},
      url = {https://doi.org/10.11648/j.ijovs.20220702.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220702.14},
      abstract = {Purpose: To investigate intraocular pressure (IOP) control, visual acuity, and complications at 1 year after Ahmed Glaucoma Valve (AGV) implantation. Methods: This was a retrospective, observational study of 35 AGV implanted patients who were followed up to 1-year post-surgery. The AGV implantation was performed at a tertiary healthcare facility in India. The IOP control, visual acuity status, and safety after AGV implantation with a specific modification of surgical technique were evaluated. Results: The study included 35 patients who underwent AGV implantation. The IOP reduced to near-normal levels post-surgery with immediate benefit being seen at Month 1, and the benefit was sustained till Month 12 as measured by the mean IOP. At all-time points post-surgery, patients had stable visual acuity. Post-surgery, the use of medication decreased over time during the study in all patients. There were no new or unexpected complications post-surgery. In most patients, AGV implantation was well-tolerated. Conclusions: AGV implantation with modified surgical technique (tube is not anchored to the sclera and partial thickness scleral flap covers the tube) works very well at intermediate term as regard to IOP control and visual acuity and it is an effective way of treating the patients with refractory glaucoma.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Intermediate Term Results with Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with a Modified Surgical Technique
    AU  - Tanuja Kate
    AU  - Rajiv Choudhary
    AU  - Divya Patel
    AU  - Urvija Choudhary
    Y1  - 2022/05/12
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijovs.20220702.14
    DO  - 10.11648/j.ijovs.20220702.14
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 65
    EP  - 72
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20220702.14
    AB  - Purpose: To investigate intraocular pressure (IOP) control, visual acuity, and complications at 1 year after Ahmed Glaucoma Valve (AGV) implantation. Methods: This was a retrospective, observational study of 35 AGV implanted patients who were followed up to 1-year post-surgery. The AGV implantation was performed at a tertiary healthcare facility in India. The IOP control, visual acuity status, and safety after AGV implantation with a specific modification of surgical technique were evaluated. Results: The study included 35 patients who underwent AGV implantation. The IOP reduced to near-normal levels post-surgery with immediate benefit being seen at Month 1, and the benefit was sustained till Month 12 as measured by the mean IOP. At all-time points post-surgery, patients had stable visual acuity. Post-surgery, the use of medication decreased over time during the study in all patients. There were no new or unexpected complications post-surgery. In most patients, AGV implantation was well-tolerated. Conclusions: AGV implantation with modified surgical technique (tube is not anchored to the sclera and partial thickness scleral flap covers the tube) works very well at intermediate term as regard to IOP control and visual acuity and it is an effective way of treating the patients with refractory glaucoma.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Rajas Eye and Retina Research Centre, Indore, India

  • Rajas Eye and Retina Research Centre, Indore, India

  • Rajas Eye and Retina Research Centre, Indore, India

  • Rajas Eye and Retina Research Centre, Indore, India

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