The effect of the hyper tensive phase on the longterm outcomes of Ahmed glaucoma valve (AGV) implantation
Maryam Yadgari 1 *, Naveed Nilforushan 2 , Kiana Hassanpour1 , Fatemeh Vafaei3
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Eye Research Center , Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Basir Eye Health Research Center, Iran University of Medical Sciences, Tehran, Iran
Abstract: To investigate the long- term ef fect of hypertensive phase(HP) on the clinical outcomes of Ahmed
Glaucoma Valve (AGV) implantation.
Methods: The records of patients with dif ferent etiologies of glaucoma who underwent AGV implantation were
retrospectively reviewed. HP was de¦ned as the IOP> 21 mm Hg during the ¦rst three months af ter
surgery. The main outcome measure was cumulative success de¦ned as 5 < IOP< 21 mmHg and 20 %
reduction f rom the baseline with or without IOP lowering medications. 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 signi¦cantly 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 signi¦cantly associated with
higher rates of surgical failure. Neovascular glaucoma was the only factor associated with the
occurrence of HP in a logistic regression model. (Odds ratio: 3.14 CI: 1.2-8.1) .
Conclusion:
In the long- term follow up the duration of survival was signi¦cantly longer in the non-HP group. In the
non-HP group, the success rate was signi¦cantly higher than the HP group
