Comparison of Ahmed glaucoma drainage implant outcomes in the anterior chamber versus pars plana

• Published in: Canadian journal of ophthalmology Vol. 59; no. 3; pp. 160 - 165
• Main Authors: Santos, Guilherme Hanato, Fernandes, Rodrigo Antonio Brant, Fernandes, Arthur Gustavo
• Format: Journal Article
• Language: English
• Published: England 01.06.2024
• Subjects: Adult; Aged; Anterior Chamber; Female; Follow-Up Studies; Glaucoma - physiopathology; Glaucoma - surgery; Glaucoma Drainage Implants; Humans; Intraocular Pressure - physiology; Male; Middle Aged; Postoperative Complications; Prosthesis Implantation - methods; Retrospective Studies; Tonometry, Ocular; Treatment Outcome; Visual Acuity - physiology
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2023.02.008

To compare long-term outcomes of eyes undergoing Ahmed glaucoma drainage implants in the anterior chamber versus the pars plana.Retrospective cohort study. Operated patients were divided into anterior-chamber or pars plana groups. Follow-up data included intraocular pressure (IOP), need for antiglaucoma medications (AGMs), and postoperative complications. Treatment success was evaluated based on the following criteria: IOP ≤21 mm Hg and no AGM use, IOP ≤21 mm Hg with or without AGM use, IOP ≤18 mm Hg and no AGM use, IOP ≤18 mm Hg with or without AGM use, IOP ≤15 mm Hg and no AGM use, and IOP ≤15 mm Hg with or without AGM use. A total of 170 eyes were selected and split into an anterior-chamber group (n = 57) and a pars plana group (n = 113). No differences between groups were found on the decrease in IOP (p = 0.612) or number of AGMs (p = 0.695) in the postoperative period. No differences regarding corneal decompensation (p = 0.554) or retinal detachment (p = 0.168) were observed between groups. The 1-year success rates for all the criteria were, respectively, 89%, 96%, 88%, 92%, 88% and 90%; the 3-year success rates for all the criteria were, respectively, 33%, 61%, 32%, 55%, 28%, and 45%; and the 5-year success rates for all the criteria were, respectively, 7%, 48%, 7%, 36%, 4% and 17%. No differences between the groups were observed for long-term outcomes of IOP, AGM use, or postoperative complications. Success rates were comparable between groups, decreased along the follow-up time, and were higher when associated with AGM use.