Short term outcome of Ahmed glaucoma valve implantation in management of refractory glaucoma in a tertiary hospital in Oman

ABSTRACT

We present outcomes of Ahmed Glaucoma Valve [AGV] implantation in treating refractory glaucoma in a tertiary hospital in Oman. Refractory glaucoma was defined as previously failed conventional glaucoma surgery and an uncontrolled intraocular pressure [IOP] of more than 21 mmHg despite treatment with three topical and/or oral therapy. This historical cohort study was conducted in 2010. Details of medical and surgical treatment were recorded. Ophthalmologists examined eyes and performed glaucoma surgeries using AGV. The best corrected distant vision, IOP, and glaucoma medications were prospectively reviewed on 1[st] day, 1[st], 6[th], 12[th] week postoperatively, and at the last follow up. Glaucoma specialists examined and treated 40 eyes with refractory glaucoma of 39 patients [20 males + 19 females]. Neo-vascular glaucoma was present in 23 eyes. Vision before surgery was <3/60 in 21 eyes. At 12 weeks, one eye had vision better than 6/12, seven eyes had vision 6/18 to 6/60, and eight eyes had vision 6/60 to 3/60. Mean IOP was reduced from 42.9 [SD 16] to 14.2 [SD 8] and 19.1 [SD 7.8] mmHg at one and 12 weeks after surgery, respectively. At 12 weeks, five [12.5%] eyes had IOP controlled without medication. In 33 [77.5%] eyes, pressure was controlled by using one or two eye drops. The mean number of preoperative anti-glaucoma medications [2.38; SD 1.1] was reduced compared to the mean number of postoperative medications [1.92; SD 0.9] at 12 weeks. We succeeded in reducing visual disabilities and the number of anti-glaucoma medications used to treat refractory glaucoma by AGV surgery