Outcome of Ahmed Glaucoma Valve in Refractory Glaucoma – Our Population Analysis

Doi: 10.36351/pjo.v37i3.1206

Abstract

Purpose:  To find out the outcomes of Ahmed Glaucoma Valve (AGV) implantation in a tertiary care hospital.

Study Design:  Retrospective case series.

Place and Duration of Study:  Shifa International Hospital Islamabad from January 2018 to July 2020.

Methods:  This retrospective case series of 19 eyes of 17 patients with refractory glaucoma included patients who underwent AGV implantation with a follow-up period of 6 months to 01 year. AGV was done as a primary procedure in 3 patients and secondary procedure in 17 patients after a previously failed trabeculectomy. All patients underwent complete eye examination, before surgery and then at 1 month, 2months, 6 months and 1 year. Goldman tonometer was used to check IOP. Complications, interventions and the number of anti-glaucoma medications (in post-operative period) needed to achieve the target pressure were noted. Success was defined as an IOP of less than 18 mm Hg, with or without a single anti-glaucoma medication.

Results:  Complete success was achieved in 57.9% and conditional success in 42.2%. The most common complication was encapsulated cyst formation in 31.6% and post-operative interventions were bleb deroofing in 10.5%, tube readjustment and tube wash in 10.5% and YAG vitreolysis in 5.3%.

Conclusion:  AGV is an effective and relatively safe procedure in refractory glaucoma irrespective of initial diagnosis and age of the patient. Encapsulated bleb was the commonest complication.

Key Words:  Ahmad Glaucoma valve, Glaucoma, Intra Ocular Pressure.