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Hypertensive Phase Following Silicone Plate Ahmed Glaucoma Valve Implantation

Won, Hun Jae MD; Sung, Kyung Rim MD, PhD

doi: 10.1097/IJG.0000000000000249
Online Articles: Original Studies

Purpose: To estimate the incidence of hypertensive phase (HP) following silicone plate Ahmed glaucoma valve implantation and to explore the risk factors for developing HP.

Methods: A total of 325 eyes from 325 patients who underwent Ahmed glaucoma valve implantation for uncontrolled intraocular pressure (IOP) and were followed for at least 1 year were included. The HP was defined as IOP>21 mm Hg (with or without IOP-lowering medication) during the first 3 months after surgery. Eyes were divided into HP and non-HP development groups. Overall success was defined as reaching an IOP>5 and <22 mm Hg with (qualified success) or without (complete success) use of an IOP-lowering medication. Risk factors associated with HP development were determined by logistic regression analysis.

Results: Among 325 eyes, 101 eyes (31.1%) experienced HP. For 24 eyes (23.8%), HP had not resolved by postoperative year 1. The HP group showed a significantly higher mean preoperative IOP than the non-HP group (37.1±11.4 vs. 32.3±11.2 mm Hg, P=0.004). The overall success rate was not significantly different between groups (81.2%, HP group vs. 89.7%, non-HP group; P=0.111); however, the complete success rate was significantly higher in the non-HP group (26.7% vs. 43.3%, P=0.003) at postoperative year 1. HP development was positively associated with preoperative IOP (odds ratio, 1.025; P=0.023).

Conclusions: Higher preoperative IOP was associated with the HP development. The non-HP group achieved a higher complete success rate when assessed at postoperative year 1.

Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

Disclosure: The authors declare no conflict of interest.

Reprints: Kyung Rim Sung, MD, PhD, Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Pungnap-2-dong, Songpa-gu, Seoul 138-736, Korea (e-mail:

Received April 21, 2014

Accepted February 15, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.