Ahmed valve implantation with MMC, 5-FU shows positive long-term results

In the long term, the adjunctive use of intraoperative mitomycin-C and postoperative 5-fluorouracil with Ahmed glaucoma valve implantation appears to produce high success rates with well-controlled IOP, according to a retrospective study by researchers in California.

Jorge A. Alvarado, MD, and colleagues at the University of California in San Francisco evaluated 6-year outcomes of Ahmed valve implantation with 0.5 mg/mL of intraoperative MMC and postoperative subconjunctival injections of 5 mg of 5-FU in 130 eyes with glaucoma. Specifically, 88 eyes underwent Ahmed valve implantation alone and 42 eyes were implanted with the Ahmed valve in combination with phacoemulsification cataract surgery.

All eyes were exposed to MMC for a median of 8 minutes and received a median of five injections of 5-FU, the authors noted.

At 6 years, the cumulative probability of valve success was 0.72 in eyes that received Ahmed valve implantation alone and 0.84 in eyes that received the implant combined with phaco.

In both groups, there was a median of two fewer medications required postoperatively than at baseline.

No postoperative medications were required in 37 eyes (42%) that underwent valve implantation alone and none were required in 15 eyes (36%) that received valve implantation with phaco, according to the study, published in the August issue of American Journal of Ophthalmology.