Comparison of Mitomycin C Trabeculectomy and Ahmed Valve Implant Surgery for Neovascular Glaucoma

ABSTRACT

PURPOSE: To compare the results of mitomycin C trabeculectomy and Ahmed valve implant surgery for neovascular glaucoma (NVG). METHODS: We reviewed the medical records of 58 patients (66 eyes) with NVG who had undergone mitomycin C trabeculectomy or Ahmed valve implant surgery in the previous 5 years. Trabeculectomy (A group) was performed in 27 eyes of 24 patients and valve implant surgery (B group) in 39 eyes of 34 patients. Intraocular pressure (IOP), visual acuity, complications and the rate of surgical success of the two groups were compared. IOP under 21 mmHg without medication was considered as complete success (CS), under 21 mmHg with medication as qualified success (QS), and IOP over 22 mmHg despite medication as failure (F). RESULTS: IOP at postoperative 2 months was lower in the trabeculectomy group than in the drainage implant surgery group (16.4 +/- 11.3 mmHg, 20.9 +/- 8.7 mmHg, P=.087), but at 12 months, there was no statistically significant difference (18.4 +/- 11.5 mmHg, 17.0 +/- 6.4 mmHg, P=.608). Visual acuity also showed no significant difference. The respective rate of success between A and B groups was 66.7% and 38.5% (CS), 25.9% and 33.3% (QS), and 7.4% and 28.2% (F), at postoperative 2 months, and 47.8% and 42.3% (CS), 30.4% and 46.2% (QS), and 21.7% and 11.5% (F), at 12 months. The most common postoperative complication was hyphema in both groups, while other complications were shallow anterior chamber, valve problems, etc. CONCLUSIONS: The type of surgery had no significant effect on the success rate of neovascular glaucoma treatment at postoperative 12 months.