Background: To investigate the long-term effect of hypertensive phase (HP) on the clinical outcomes of Ahmed glaucoma valve (AGV) implantation.
Method: The records of patients with different etiologies of glaucoma who underwent AGV implantation with at least 3 years of follow-up were retrospectively reviewed. HP was defined as the IOP > 21 mm Hg during the first three months after surgery. The main outcome measure was cumulative success defined as 5 < IOP ≤ 21 mmHg and 20% reduction from the baseline with or without IOP lowering medications. Results that do not achieve cumulative success or undergo glaucoma reoperation during the follow-up period are considered failures. The secondary outcome measures were intraocular pressure (IOP) and the number of glaucoma medications.
Results: A total of 120 patients (28 patients of HP, 92 patients without HP) with an average age (± SD) of 48.9 ± 19.6 years and a mean follow-up of 4.5 ± 1.4 years were enrolled. The mean duration of survival was 5.3 ± 0.5 years in HP which was significantly shorter than 6.4 ± 0.2 years in non-HP (log rank = 4.2, P = 0.04). Mean IOP and number of IOP lowering agents were higher in postoperative visits at 1,2, 3, and 4 years in HP patients compared with non-HP (all Ps < 0.01). Higher baseline IOP was significantly associated with higher rates of surgical failure.
Conclusion: In the long-term follow-up, the duration of survival was significantly longer in the non-HP group. In the non-HP group, the failure rate was significantly lower than the HP group.
Keywords: Failure rate; Glaucoma drainage devices; Hypertensive phase; Intraocular pressure; Success rate.
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.