A modification to the surgical technique of Ahmed glaucoma valve
(AGV) implantation without plate sutures or surgical glue products has a similar safety and efficacy profile than the standard procedure, in the short and mid-term follow-up.
The purpose of this study was to assess the safety and efficacy of a modified AGV implantation technique without plate sutures.
A retrospective case-control study including patients seen in the Glaucoma service of an academic institution. Patients that underwent a modified AGV implantation without plate sutures were included as cases and patients that underwent standard AGV implantation, as controls. Success was defined as intraocular pressure (IOP) reduction >20%, IOP >5 and <21 without the need for additional surgical intervention, and maintenance of light perception.
A total of 170 eyes were included. Mean (range) follow-up was 11.2±7.39 (3 to 24) months. There was no statistically significant difference in visual acuity and IOP between the groups during the postoperative period. In a univariate analysis, there was a larger decrease in IOP for the no plate suture group at the 6 months (−15.6±11.6 vs. −11.5±10.5, P
=0.04) and 1 year (−16.4±10.4 vs. −11.1±10.4, P
=0.02) visits. There was also a larger decrease in number of medications in the no plate suture group in the 3 months (−1.65±1.5 vs. −1.13±1.22, P
=0.02), 6 months (−1.55±1.44 vs. −0.98±1.3, P
=0.01) and 1 year (−1.70±1.5 vs. −1.04±1.2, P
=0.04) visits. However, those differences were not confirmed by a multivariable model after adjusting for glaucoma type and number of previous glaucoma surgeries. No differences in the trajectory of the survival curves were noted between groups (P
The comparison of short and mid-term outcomes of patients undergoing AGV implantation using both techniques showed similar outcomes and success rates.