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Abstract #10221 Published in IGR 6-1
Baerveldt-350 implant versus Ahmed valve for refractory glaucoma: a case-controlled comparison
Syed HM; Law SK; Nam SH; Li G; Caprioli J; Coleman AJournal of Glaucoma 2004; 13: 38-45
PURPOSE: To compare the efficacy of intraocular pressure (IOP) control of the Baerveldt-350 implant with tube ligature and the Ahmed valve in patients with refractory glaucoma. PATIENTS AND METHODS: Four hundred and seventy glaucoma drainage device procedures from July 1995 to July 2001 (six years) were reviewed retrospectively. Thirty-two cases of Baerveldt-350 implantation performed in patients with glaucoma refractory to medical treatment and filtering procedures, without previous drainage device or cyclodestructive procedures, and with a minimum of one year of follow-up were identified. Thirty-two cases of Ahmed valve implantation were matched case by case with 32 Baerveldt-350 cases for age, race, gender, glaucoma subtype, previous ocular history, preoperative IOP, and surgeon who performed the implantation. The two groups were compared for IOP control, visual outcome, complication rate, and surgical success rate. Surgical success rate was defined as an IOP reduction ≥ 30% and final IOP > 5 and < 22 mmHg, without devastating complications. RESULTS: Over a follow-up period of one year, no statistically significant differences were detected between the Baerveldt-350 implant versus Ahmed valve for IOP control (12.1 ± 5.3 versus 13.6 ± 5.6 mmHg, respectively, at a power of 90% to detect a difference of 3.2 mmHg between the two groups and p = 0.05), surgical success rate (65.6 versus 65.6%, respectively, complete and qualified combined), postoperative hypotony rate (37.5 versus 34.4%, respectively), and visual acuity changes of more than one line in Snellen visual acuity (43.3 versus 29.0%, respectively). CONCLUSIONS: In a case-controlled comparison, the Baerveldt-350 implant and the Ahmed valve had similar IOP control and surgical outcomes in patients with refractory glaucoma at one year of follow-up.
Dr. H.M. Syed, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA 90095, USA
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)