Comparison of Silicone- and Porous-Plate Ahmed Glaucoma Valves

Tina M Roa, Peter A Netland, Vital P Costa, Steven R Sarkisian Jr, Lama A Al-Aswad, Marlene R Moster, Iqbal I K Ahmed, Tina M Roa, Peter A Netland, Vital P Costa, Steven R Sarkisian Jr, Lama A Al-Aswad, Marlene R Moster, Iqbal I K Ahmed

Abstract

Purpose: Our aim was to evaluate and compare the clinical outcomes after implantation of the silicone-plate (model FP7) and porous polyethylene-plate (model M4) Ahmed Glaucoma Valves.

Patients and methods: This was a prospective, multicenter, comparative series. A total of 52 eyes (52 patients) were treated with either the silicone or porous plate Ahmed Glaucoma Valve implant. Hypertensive phase was defined as intraocular pressure >21 mmHg during the first 3 months postoperatively. Success was defined as 5 mmHg ≤intraocular pressure ≤21 mmHg (with or without additional glaucoma medications), without loss of light perception and without additional glaucoma procedures. Patients were monitored for 1 year after surgery.

Results: The pre-operative intraocular pressure was 29.9 ± 6.6 mmHg and 33.8 ± 10.5 in the silicone-plate and porous-plate groups, respectively (P = 0.118). At 12 months after surgery, the mean intraocular pressure was 13.6 ± 4.7 mmHg in the silicone-plate group and 17.9 ± 10.9 mmHg in the porous-plate group (P = 0.141). The mean number of glaucoma medications at 12 months was 1.64 ± 1.40 mmHg and 1.89 ± 1.54 mmHg in the silicone- and porous-plate groups, respectively (P = 0.605). Hypertensive phase was not significantly different in the two groups (50.0% of the silicone-plate and 57.7% of the porous-plate groups, P = 0.578). At 12 months after surgery, the percent success for the silicone-plate and porous-plate groups was 88.5% and 53.8%, respectively (P = 0.005). Complications were similar in the two groups.

Conclusion: The porous-plate Ahmed Glaucoma Valve showed similar average intraocular pressure reduction compared with the silicone-plate model. At 12 months after surgery, there was a significantly lower success rate in the porous-plate compared with the silicone-plate group.

Keywords: Ahmed Glaucoma Valve; Medpor; glaucoma drainage implant; model FP7; model M4; porous polyethylene.

Conflict of interest statement

Dr. Roa and Dr. Netland have no proprietary interest or conflict of interest related to the devices described in this study. Dr Costa received personal fees from Alcon and Iridex; grants, personal fees from Allergan, outside the submitted work. Dr. Sarkisian received grant support from and/or was a consultant/advisor for Alcon, Allergan, Bausch & Lomb, Beaver-Visitec International, Inc., Katena Products, Inc, Ocular Science, Omeros, Santen, Inc., Sight Sciences, and Glaukos; consulting fees from New World Medical, Alcon, Sight Sciences, and Glaukos; speaker honoraria from Alcon; and has equity ownership in Sight Sciences and Ocular Science, unrelated to this work. Dr Al-Aswad reports grants from New World Medical, during the conduct of the study; grants from Topcon, owns shares from Globechek, and personal fees from Aries and Topcon, outside the submitted work. Dr. Ahmed received consulting fees from Alcon, Allergan, New World Medical, and Glaukos; and speaker honoraria from Alcon, Allergan, and New World Medical. Dr. Moster received consulting fees from Alcon, Allergan, Bausch and Lomb, Glaukos, Aerie, and Qura; and speaker honoraria from Alcon, Allergan, Aerie, and Bausch and Lomb. The authors report no other conflicts of interest in this work.

© 2020 Roa et al.

Figures

Figure 1
Figure 1
Mean intraocular pressure after M4 and FP7 Ahmed Glaucoma Valve implantation. The intraocular pressure was significantly reduced in both groups compared with baseline (P Abbreviations: Pre, before surgery; D, day(s); M, month(s).
Figure 2
Figure 2
Number of glaucoma medications at baseline and postoperatively after M4 and FP7 Ahmed Glaucoma Valve implantation. The number of medications was significantly reduced in both groups compared with baseline (P Abbreviations: Pre, before surgery; D, day(s); M, month(s).
Figure 3
Figure 3
Kaplan–Meier curve cumulative probability of success in patients treated with model M4 and model FP7 Ahmed Glaucoma Valve implantation. Success was defined as 5 mmHg ≤intraocular pressure ≤21 mmHg (with or without medications), without loss of light perception and without additional glaucoma procedures. The success of eyes after model FP7 was significantly higher compared with model M4 implantation (P = 0.005).
Figure 4
Figure 4
Kaplan–Meier curve cumulative probability of success in patients treated with model M4 and model FP7 Ahmed Glaucoma Valve implantation. In this analysis, success was defined as 30% lowering of intraocular pressure from baseline (with or without medications), without loss of light perception and without additional glaucoma procedures. The success of eyes after model FP7 was significantly higher compared with model M4 implantation (P = 0.014).

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