advertisement
Abstract #99138 Published in IGR 22-4
Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Postoperative Use of Prednisolone Acetate Versus Difluprednate
Kao BW; Fong CW; Yu Y; Ying GS; Gedde SJ; Han YOphthalmology. Glaucoma 2022; 5: 468-475
PURPOSE: To evaluate the effect of postoperative topical prednisolone acetate and difluprednate on surgical outcomes of Ahmed Glaucoma Valve (AGV) implantation. DESIGN: Retrospective comparative case series PARTICIPANTS: The study population consisted of 102 eyes of 90 patients, including 52 eyes that received prednisolone acetate 1% (PF group) and 50 eyes that received difluprednate 0.05% (DZ group). METHODS: The medical records of consecutive patients who underwent AGV implantation at the University of California San Francisco were retrospectively reviewed. Patients in the PF group received prednisolone acetate 1% 6-8 times per day tapered over 5-6 months, and patients in the DZ group received difluprednate 0.05% 4 times daily tapered over 4 months postoperatively. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), number of glaucoma medications, visual acuity (VA), postoperative complications, and rate of treatment success. RESULTS: At 1 year, IOP (mean ± standard deviation) was 12.4 ± 3.7 mmHg in the DZ group and 13.0 ± 4.0 mmHg in the PF group (P = 0.49). The number of glaucoma medications was 0.72 ± 0.71 in the DZ group and 1.09 ± 0.91 in the PF group (P = 0.04), with a reduction from baseline of 2.5 ± 1.0 glaucoma medications in the DZ group and 1.8 ± 1.6 medications in the PF group (P = 0.01). LogMAR VA (mean ± SD) was 0.55 ± 0.80 in the DZ group and 0.59 ± 0.65 in the DZ group after 1 year of follow-up (P = 0.81). The cumulative probability of success was 95.8% in the DZ group and 93.5% in the PF group at 1 year (P = 0.61). Postoperative complications occurred in 4 eyes (7.7%) in the DZ group and 6 eyes (12%) in the PF group (P = 0.52). CONCLUSIONS: After 1 year, postoperative treatment with difluprednate 0.05% following AGV implantation resulted in similar IOP with use of fewer glaucoma medications compared with prednisolone acetate 1%. The rates of treatment success and surgical complications were comparable between the two groups during the first year of follow-up.
Department of Ophthalmology, University of California, San Francisco, San Francisco, CA.
Full article