TY - JOUR
T1 - The Ahmed shunt versus the Baerveldt shunt for refractory glaucoma
T2 - A single-surgeon comparison of outcome
AU - Tsai, James C.
AU - Johnson, Cameron C.
AU - Dietrich, Mary S.
N1 - Funding Information:
Supported in part by the Homer McK. Rees Scholar Award (JCT), the Eye Surgery Fund, New York, New York (JCT), the Siegal Research Fund, New York, New York (JCT), and an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York. The authors have no proprietary interest in any of the materials used in this study.
PY - 2003/9/1
Y1 - 2003/9/1
N2 - Purpose: To compare the surgical outcome of Baerveldt and Ahmed shunt implants in the treatment of refractory glaucoma. Design: Retrospective, nonrandomized, comparative trial. Methods and Participants: Medical records of 118 consecutive patients who underwent glaucoma shunt implantation (70 Baerveldt, 48 Ahmed) by a single surgeon were reviewed. Main Outcome Measures: The primary outcome measure was surgical success (6 mmHg ≤ intraocular pressure [IOP] ≤ 21 mmHg without additional glaucoma surgery or devastating complication) at 12 months after surgery. Secondary outcome measures included mean IOP and number of medications used at the following postoperative visits: day 1, 1 week, 1 month, 3 months, 6 months, and every 6 months thereafter. Additional outcome measures evaluated include visual acuities, prevalence and timing of postoperative choroidal detachment, and clinical bleb encapsulation. Results: Survival curve analysis showed success rates of 82.9% of the Ahmed group and 72.9% of the Baerveldt group at 12 months after surgery (P = 0.257). Patients in the Ahmed group exhibited lower IOPs at 1 day (P < 0.001) and 1 week (P < 0.001) after surgery and were taking fewer glaucoma medications at 1 week (P < 0.001) and 1 month (P < 0.001) after surgery. A higher proportion of Ahmed patients experienced clinical bleb encapsulation than did the Baerveldt patients (60.4% vs. 27.1%; P < 0.001). Moreover, the first observation of postoperative bleb encapsulation was sooner after surgery for the Ahmed patients (50.0 ± 43.8 days) than for the Baerveldt patients (69.8 ± 22.6 days; P = 0.001). Conclusions: The Ahmed shunt implant exhibited better control of IOP in the early postoperative period (1 day and 1 week) with patients requiring fewer glaucoma medications at 1 week and 1 month after surgery. There was both a higher prevalence and earlier onset of bleb encapsulation observed with the Ahmed shunt implant.
AB - Purpose: To compare the surgical outcome of Baerveldt and Ahmed shunt implants in the treatment of refractory glaucoma. Design: Retrospective, nonrandomized, comparative trial. Methods and Participants: Medical records of 118 consecutive patients who underwent glaucoma shunt implantation (70 Baerveldt, 48 Ahmed) by a single surgeon were reviewed. Main Outcome Measures: The primary outcome measure was surgical success (6 mmHg ≤ intraocular pressure [IOP] ≤ 21 mmHg without additional glaucoma surgery or devastating complication) at 12 months after surgery. Secondary outcome measures included mean IOP and number of medications used at the following postoperative visits: day 1, 1 week, 1 month, 3 months, 6 months, and every 6 months thereafter. Additional outcome measures evaluated include visual acuities, prevalence and timing of postoperative choroidal detachment, and clinical bleb encapsulation. Results: Survival curve analysis showed success rates of 82.9% of the Ahmed group and 72.9% of the Baerveldt group at 12 months after surgery (P = 0.257). Patients in the Ahmed group exhibited lower IOPs at 1 day (P < 0.001) and 1 week (P < 0.001) after surgery and were taking fewer glaucoma medications at 1 week (P < 0.001) and 1 month (P < 0.001) after surgery. A higher proportion of Ahmed patients experienced clinical bleb encapsulation than did the Baerveldt patients (60.4% vs. 27.1%; P < 0.001). Moreover, the first observation of postoperative bleb encapsulation was sooner after surgery for the Ahmed patients (50.0 ± 43.8 days) than for the Baerveldt patients (69.8 ± 22.6 days; P = 0.001). Conclusions: The Ahmed shunt implant exhibited better control of IOP in the early postoperative period (1 day and 1 week) with patients requiring fewer glaucoma medications at 1 week and 1 month after surgery. There was both a higher prevalence and earlier onset of bleb encapsulation observed with the Ahmed shunt implant.
UR - https://www.scopus.com/pages/publications/0041429360
U2 - 10.1016/S0161-6420(03)00574-8
DO - 10.1016/S0161-6420(03)00574-8
M3 - Article
C2 - 13129882
AN - SCOPUS:0041429360
SN - 0161-6420
VL - 110
SP - 1814
EP - 1821
JO - Ophthalmology
JF - Ophthalmology
IS - 9
ER -