Long-term outcomes of the Şimşek technique vs long scleral tunnel method in Ahmed glaucoma valve implantation.

PURPOSE: To evaluate the long-term outcomes of the Şimşek technique, a modified Ahmed Glaucoma Valve (AGV) implantation using a scleral tunnel created with a 6-0 Prolene suture.

METHODS

This retrospective, comparative study was conducted at a tertiary referral center and included glaucoma patients who underwent AGV implantation via either the Şimşek technique (Group 1) or the classic long scleral tunnel technique (Group 2), with at least 12 months of follow-up. Group 1 included 44 patients (mean age: 54.8 ± 19.3 years), and Group 2 consisted of 48 patients (mean age: 50 ± 22.8 years). Pre- and postoperative assessments included best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of anti-glaucomatous medications (NAGM), surgical success, and complications.

RESULTS

Mean follow-up duration was 22.6 ± 7.6 months in Group 1 and 27.3 ± 14.9 months in Group 2. No statistically significant differences were found between groups in IOP reduction (p = 0.237), NAGM at final visit (p = 0.054), or surgical success (p = 0.79). Complication rates were 54.5% in Group 1 and 56.3% in Group 2 (p = 1.000). Notably, no cases of tube exposure were observed in Group 1. Group 1 showed a significant improvement in BCVA compared to Group 2 (p = 0.003).

CONCLUSIONS

The Şimşek Technique yielded comparable IOP control and surgical success to the conventional method, with significantly improved BCVA and reduced tube exposure risk. These findings suggest its suitability, especially in patients with thin conjunctiva or where visual function preservation is critical. Further prospective studies are warranted.