Long-term follow-up of primary glaucoma urgery with ahmed glaucoma valve implant veru trabeculectomy

Purpoe To compare the long-term reult of trabeculectomy and Ahmed glaucoma valve implant in the initial urgical management of primary open- and cloed-angle glaucoma. Deign Randomized controlled clinical trial. Method One eye each of conecutive patient with primary glaucoma and without prior intraocular urgery wa randomized to receive either trabeculectomy or the Ahmed implant. etting Large univerity-affiliated eye hopital in Columbo, ri Lanka. Reult Of 123 patient, 64 were randomized to trabeculectomy and 59 to the Ahmed implant. With a mean follow-up of 31 month, the trabeculectomy group had tatitically lower intraocular preure (IOP) during the firt potoperative year. After the firt year, the IOP were comparable. No tatitically ignificant difference between group were noted for potoperative viual acuity, viual field, anterior chamber depth, and hort-term or long-term complication. Adjunctive medication requirement wa comparable for both group. The cumulative probabilitie of ucce (IOP <21 mm Hg and at leat 15% reduction in IOP from preoperative level) at the final follow-up period (month, 41–52) were 68.1% for trabeculectomy and 69.8% for Ahmed implant (P = .86). Concluion Lower IOP were noted for the trabeculectomy group during the firt year. With longer follow-up, the IOP and the cumulative probabilitie of ucce were comparable between the two group.