Outcomes of Ahmed and Baerveldt Glaucoma Drainage Devices in Japanese Patients.

PRÉCIS: Preoperative conditions and outcomes of the Ahmed glaucoma valve and Baerveldt glaucoma implant were assessed. Differences were observed in disease type and surgical history between the 2 groups. Comparatively, the Baerveldt glaucoma implant had more complications.

PURPOSE: To evaluate the preoperative conditions and surgical outcomes of the Ahmed glaucoma valve and the Baerveldt glaucoma implant in clinical practice.

PATIENTS AND

METHODS

Patients who underwent glaucoma tube-shunt surgery using the Ahmed glaucoma valve or Baerveldt glaucoma implant at Kyoto University Hospital between January 1, 2015, and December 31, 2021, were included. Patients with previous glaucoma tube shunt surgeries were excluded. Data on preoperative conditions, intraocular pressure, glaucoma medication scores, visual acuity, and complications were retrospectively obtained from medical records.

RESULTS

We analyzed 154 eyes (Ahmed glaucoma valve, 102 eyes; Baerveldt glaucoma implant, 52 eyes) in total. No significant differences were observed between the groups except for disease type and surgical history-neovascular glaucoma and no prior glaucoma surgery were more common in the Ahmed glaucoma valve group, whereas exfoliation glaucoma, primary open angle glaucoma, and history of glaucoma surgery were more frequent in the Baerveldt glaucoma implant group. At 36 months, mean intraocular pressure and medication scores were 14.2±4.0 mm Hg and 2.1±1.5 for Ahmed glaucoma valve, and 13.0±4.6 mm Hg and 1.7±1.7 for Baerveldt glaucoma implant, respectively, with no significant differences. The 60-month cumulative success rates were 58.1% for Ahmed glaucoma valve and 60.6% for Baerveldt glaucoma implant under Definition A (intraocular pressure range: 6-21 mm Hg) and 57.5% for Ahmed glaucoma valve and 57.5% for Baerveldt glaucoma implant under Definition B (intraocular pressure range: 6-18 mm Hg). The Baerveldt Glaucoma Implant group revealed a higher incidence of postoperative complications, with hypotony being the most common complication.

CONCLUSION

In this large-scale real-world study, no significant differences in surgical outcomes were observed between the Ahmed glaucoma valve and the Baerveldt glaucoma implant. However, it should be noted that the implant choice tended to be influenced by glaucoma type and surgical history, reflecting differences in disease background between the treatment groups.