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Outcomes and Complications of Ahmed Tube Implantation in Asian Eyes

Choo, Jessica Qian Hui, MBBS*; Chen, Ziyou David, MBBS*; Koh, Victor, MMed (Ophthalmology)*; Liang, Shen, PhD; Aquino, Cecilia Maria, MMed (Ophthalmology)*; Sng, Chelvin, MRCSEd (Ophthalmology)*; Chew, Paul, FRCSEd (Ophthalmology)*

doi: 10.1097/IJG.0000000000001004
Original Study: PDF Only

Purpose: There is a lack of long-term Asian studies on the efficacy and safety of Ahmed glaucoma valve (AGV) implantation. This study seeks to determine the outcomes and complications of AGV implantation in Asians.

Methods: Retrospective review of AGV surgeries performed at a single centre in Singapore was conducted. 76 patients with primary and secondary glaucoma who underwent their first AGV surgery from 1st January 2010 to 31st December 2012 were considered for our study. Primary outcomes evaluated were: failure, intra-ocular pressure, best-corrected visual acuity (BCVA), number of IOP-lowering medications and complications. Failure was defined by: IOP >21▒mm Hg on two consecutive visits after 3 months, IOP ≤5▒mm Hg on two consecutive visits after 3 months, reoperation for glaucoma, removal of implant or loss of light perception vision.

Results: Mean follow-up duration was 33.2±6.9 months. There was significant reduction in IOP (mean reduction 25.9%, P<0.001) and number of IOP-lowering medications (mean reduction 77.8%, P<0.001) at 3 years. Absolute failure rate was 23.9% at 3 years with no difference between eyes with or without previous trabeculectomy and between eyes with primary or secondary glaucoma. Occurrence of post-operative hyphema was a significant risk factor for failure. Commonest post-operative complications were hyphema and tube exposure.

Conclusion: At 3 years after AGV surgery in Asian eyes, less than one-quarter of the eyes fulfilled the criteria for surgical failure.

*Department of Ophthalmology, National University Health System, Singapore

Department of Biostatistics, National University Health System, Singapore

*Address of Institution at which work was carried out: Department of Ophthalmology, National University Health System, 1E Kent Ridge Road, Level 7, NUHS Tower Block, Singapore 119228.

There are no funding sources for this study.

Disclosure: The authors declare no conflict of interest.

Reprints: Victor Koh, MMed (Ophthalmology), Department of Ophthalmology, National University Health System, 1E Kent Ridge Road, Level 7, NUHS Tower Block, Singapore 119228 (e-mail: victor_koh@nuhs.edu.sg).

Received February 11, 2018

Accepted June 8, 2018

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