# Long-Term Outcome After Implantation of the Ahmed Glaucoma Valve in Refractory Glaucoma

## TL;DR

This study evaluates the long-term effectiveness of Ahmed Glaucoma Valve implantation in patients with difficult-to-treat glaucoma, showing significant and sustained pressure reduction.

## Contribution

A retrospective analysis of AGV outcomes in refractory glaucoma patients over seven years, highlighting success rates and complications.

## Key findings

- AGV implantation achieved a 51.6% absolute success rate and 84.9% qualified success rate in reducing intraocular pressure.
- Intraocular pressure decreased by 42.4% one year post-surgery, with a significant reduction in needed medications.
- Ocular hypotony was the most common complication, occurring in 30.8% of patients at discharge.

## Abstract

Background

Glaucoma is the second leading cause of blindness, requiring effective and sustainable management through pharmacological, laser-assisted, or surgical therapy. The Ahmed Glaucoma Valve (AGV) (New World Medical, Inc., Rancho Cucamonga, CA) is a surgically implanted drainage system that can provide long-term reduction in intraocular pressure. This study retrospectively evaluates the outcomes of patients with complicated glaucoma, refractory to medical therapy, who had an AGV implanted at the Department of Ophthalmology of St. Johannes Hospital in Dortmund, Germany.

Material and methods

Preoperative and postoperative data of glaucoma patients who underwent an Ahmed valve implantation from January 2008 to December 2012 were obtained from hospital medical records over a maximum follow-up time of seven years. The evaluation included the indication for implantation, postoperative complications, and treatment success.

Results

The most common diagnosis was primary chronic open-angle glaucoma (42.8%), followed by secondary glaucoma (38.4%); 28.9% of patients were previously treated with trabeculectomy. The absolute success rate after one year was 51.6%, and the qualified success rate was 84.9%. A significant and sustained reduction of the intraocular pressure of 42.4%, from 28.9 ± 11.0 to 16.64 ± 7.2 mmHg, was observed after one year. The number of local medications required after the ocular surgery significantly decreased over time. The most common complication was ocular hypotony (30.8% at discharge).

Conclusion

The therapeutic success of AGV implantation in glaucoma patients in our clinic was very high. A significant and sustained reduction of intraocular pressure was achieved. One year postoperatively, complications occurred only sporadically.