Abstract:

Objective To evaluate the efficacy and safety of two different types of Ahmed Glaucoma Valve (AGV) in the treatment of refractory glaucoma. Design Retrospective case control study. Participants Patients with refractory glaucoma in whom AGV implantation was performed in our hospital between July 2010 and July 2015. Methods The patients were divided into two groups according to the different type of AGV: FP8 group and FP7 group. Patients underwent FP8 or FP7 Ahmed Glaucoma Valve implantation. Patients were followed at post-operative day 1, week 1, month 1, month 3, month 6, and month 12. Main Outcome Measures The intraocular pressure (IOP), number of antiglaucoma medication used, surgical success rate, best correct visual acuity (BCVA), and postoperative complications. Results The preoperative IOP of FP8 and FP7 groups was 39.78±7.37 mmHg and 41.68±9.60 mmHg respectively. The post-operative mean IOP of FP8 and FP7 groups at all follow-up time point was 15.13±7.41 mmHg and 16.32±6.94 mmHg respectively, significantly lower than preoperative value (all P<0.001). The mean number of antiglaucoma medication of FP8 and FP7 groups before operation was 3.44±0.78 and 3.35±0.66 respectively. It was 0.28±0.67 and 0.33±7.36 respectively post-operatively (all P<0.001). At the 12-month follow-up visit, the BCVA was decreased in 5 eyes of the FP8 group and in 8 eyes of the FP7 group, unchanged in 19 eyes of the FP8 group and in 22 eyes of the FP7 group, and improved in 22 eyes of the FP8 group and in 30 eyes of the FP7 group. There were no significant differences in visual changes between the 2 groups at post-operative 12 months(χ2=0.049, P=0.824). Kaplan-Meier survival curves showed that the success rate was 69.6% for FP8 group and 78.3% for the FP7 group at follow-up endpoint. There was no significant difference between the two groups (P=0.499). Conclusions  The AGV implantation may be an effective method in managing refractory glaucoma. The two different types of AGV had similar efficacy in treatment of refractory glaucoma. （Ophthalmol CHN， 2018, 27： 367-371）

Key words: refractory glaucoma, Ahmed glaucoma valve