Ahmed Glaucoma Valve Implant v trabeculectomy in the urgical treatment of glaucoma: a randomized clinical trial

PURPOE: To compare the hort- and intermediate-term reult of two commonly ued glaucoma urgical procedure, trabeculectomy and Ahmed glaucoma valve implant. METHOD: A randomized clinical trial wa performed at two international center. One eye each of conecutive patient requiring glaucoma urgery for intraocular preure control wa randomized to receive either trabeculectomy or the Ahmed implant. REULT: Of the 117 patient, 62 were randomized to trabeculectomy and 55 to the Ahmed implant. With a mean follow-up of 9.7 month, the trabeculectomy group had tatitically lower intraocular preure at week 6 to 15 (12.6 mm Hg v 16.4 mm Hg) and month 11 to 13 (11.4 mm Hg v 17.2 mm Hg) than the Ahmed implant group. Compared with preoperative tatu, no tatitically ignificant difference between group were noted for viual acuity, viual field, len tatu, and final anterior chamber depth. The cumulative probabilitie of ucce (intraocular preure <21 mm Hg and at leat 15% reduction in intraocular preure from preoperative level) were 83.6% for trabeculectomy and 88.1% for Ahmed implant (P = .43). However, the Ahmed implant group had a greater adjunctive medication requirement. On the lat viit, 10 of the trabeculectomy eye and 19 of the Ahmed implant eye required at leat one topical medication (P = .01). There wa no tatitically ignificant difference in the rate of complication between the two group. CONCLUION: Lower mean intraocular preure were noted for the trabeculectomy group. All other reult, including ucce (a defined in thi tudy) and frequency of complication, were comparable between the two group.