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Ahmed valves with no patch grafts may manage glaucoma long term
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SAN FRANCISCO — Glaucoma may be managed long term with Ahmed valves implanted without using patch grafts, according to a presenter here.
Higher initial IOP, younger age and inferotemporal location were risk factors for valve failure, Felix Gil-Carrasco, MD, said in a poster presented at the American Glaucoma Society annual meeting.
The retrospective review included 840 randomly selected records of approximately 8,700 patients operated with an Ahmed valve over a 16-year period.
A total of 912 Ahmed valves (New World Medical) implanted without using a tube-covering patch and 8,152 corresponding office visits were analyzed for IOP control, complications and rate of failure.
Surgical failure was defined as loss of light perception, a need for additional IOP-lowering surgery, IOP greater than 21 mm Hg with or without massage and/or medications, or IOP less than 5 mm Hg on two consecutive office visits at least 1 month apart.
Mean follow-up was 29.3 months.
Postoperatively, implant survival was 81.8% at 6 months, 76.4% at 1 year, 62.6% at 5 years, and 49% at 10 and 15 years.
Valve removal was necessary in 10 eyes, tube retraction occurred in seven eyes, and tube exposure occurred in four eyes. Glaucoma-related loss of light perception occurred in 35 eyes, and non-glaucoma-related loss of light perception occurred in 20 eyes.
Disclosure: Gil-Carrasco has no relevant financial disclosures.