The Long Term Outcome of Ahmed Glaucoma Valve Insertion in Neovascular Glaucoma

Purpose: To evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation for neovascular glaucoma (NVG), in short, intermediate, and long term follow ups. Patients and Methods: The present study was a retrospective review of 23 eyes of 23 patients with NGV who underwent AGV implantation at Imam Hussein Medical Center, Tehran, Iran, between January 2008 and March 2017. Pre and post operative intraocular pressure (IOP), visual acuity, surgical success rate, number of medications, and complications were recorded. The primary outcome was surgical success defined in terms of 5 ≤ IOP ≤ 21 mmHg and at least 20 % reduction in IOP without glaucoma medication (complete success), or with medications (qualified success). The sum of complete success and qualified success was reported as cumulative success. Results: The mean follow up period was 4.69 years (range, 2-10 years). The mean IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years (P < 0.001). The cumulative surgical success rate at 1 year, 2 years and 3 years were 91.3 %, 82.6 %, 78.3 % respectively. The mean number of drugs needed to control IOP was significantly lower compared to preoperative mean at each postoperative visit up to three years. Conclusion: It seems that AGV insertion is a safe and effective surgical method to treat neovascular glaucoma with acceptable success rates up to three years post operatively. More prospective studies with higher number of participants are recommended to better evaluate the success rate of AVG implantation to treat patients with neovascular glaucoma.