Journal of glaucoma · 2026
Trabeculectomy After Ahmed Glaucoma Valve Implantation Versus Repeat Trabeculectomy.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Yoon Jooyoung, Sung Kyung Rim
Аннотация
PURPOSE: To compare outcomes of trabeculectomy (TRAB) performed after Ahmed glaucoma valve (AGV) implantation with those of repeat TRAB and to identify factors related to surgical failure.
METHODS: In this retrospective study, patients who underwent a second TRAB were divided into 2 groups: TRAB after AGV implantation (TaA) and repeat TRAB (TaT). Primary outcome was surgical success, defined as a postoperative intraocular pressure (IOP) <21 mm Hg or a ≥20% reduction from baseline, with or without glaucoma medications. Preoperative and postoperative IOP and IOP reduction rates were compared through paired-sample t tests. Surgical success rates were analyzed with Kaplan-Meier survival analysis. Risk factors for surgical failure were evaluated with the Cox proportional hazards model.
RESULTS: Forty-three eyes were included (TaA, n=20; TaT, n=23), and the TaA group had more secondary glaucoma ( P =0.004) and higher baseline IOP ( P <0.001). Postoperative IOP, IOP reduction rates, and success rates were comparable between the 2 groups up to 2 years. Higher postoperative IOP at 1 month was associated with failure in both groups [hazard ratio (HR) 1.151, P =0.036 in TaA; HR 1.188, P =0.009 in TaT]. The postoperative 1-month IOP ≥17.5 mm Hg was associated with an increased risk of failure.
CONCLUSIONS: TRAB after AGV implantation achieved similar postoperative outcomes to those of repeat TRAB, supporting its role as a potential secondary option in intractable glaucoma treatment. Early postoperative IOP is a favorable prognostic marker, highlighting the importance of stabilizing IOP during this period.
PRCIS: Trabeculectomy after Ahmed valve implantation showed outcomes comparable to repeat trabeculectomy, with prior shunt surgery not precluding success. Early postoperative intraocular pressure at 1 month was a strong predictor of long-term surgical success.
METHODS: In this retrospective study, patients who underwent a second TRAB were divided into 2 groups: TRAB after AGV implantation (TaA) and repeat TRAB (TaT). Primary outcome was surgical success, defined as a postoperative intraocular pressure (IOP) <21 mm Hg or a ≥20% reduction from baseline, with or without glaucoma medications. Preoperative and postoperative IOP and IOP reduction rates were compared through paired-sample t tests. Surgical success rates were analyzed with Kaplan-Meier survival analysis. Risk factors for surgical failure were evaluated with the Cox proportional hazards model.
RESULTS: Forty-three eyes were included (TaA, n=20; TaT, n=23), and the TaA group had more secondary glaucoma ( P =0.004) and higher baseline IOP ( P <0.001). Postoperative IOP, IOP reduction rates, and success rates were comparable between the 2 groups up to 2 years. Higher postoperative IOP at 1 month was associated with failure in both groups [hazard ratio (HR) 1.151, P =0.036 in TaA; HR 1.188, P =0.009 in TaT]. The postoperative 1-month IOP ≥17.5 mm Hg was associated with an increased risk of failure.
CONCLUSIONS: TRAB after AGV implantation achieved similar postoperative outcomes to those of repeat TRAB, supporting its role as a potential secondary option in intractable glaucoma treatment. Early postoperative IOP is a favorable prognostic marker, highlighting the importance of stabilizing IOP during this period.
PRCIS: Trabeculectomy after Ahmed valve implantation showed outcomes comparable to repeat trabeculectomy, with prior shunt surgery not precluding success. Early postoperative intraocular pressure at 1 month was a strong predictor of long-term surgical success.