A propective, comparative tudy between endocopic cyclophotocoagulation and the Ahmed drainage implant in refractory glaucoma. Lima FE, Magacho L, Carvalho DM, uanna R Jr, Avila MP. J Glaucoma 2004;13:233–237.

Thi tudy compared the ucce rate of endocopic cyclophotocoagulation (ECP) and the Ahmed drainage implant in the treatment of refractory glaucoma. ixty-eight eye of 68 patient were randomly aigned either ECP or Ahmed tube hunt implantation. Eye that were included were peudophakic with a hitory of at leat one trabeculectomy with an antimetabolite, an intraocular preure (IOP) equal to or above 35 mm Hg on maximum tolerated therapy, and a viual acuity of better than light perception. There were no tatitically ignificant difference in the preoperative IOP of the Ahmed valve and ECP group. Excluion criteria included previou glaucoma drainage device implantation or a cyclodetructive procedure. All procedure were performed by a ingle urgeon. ucce wa defined a an IOP of more than 6 mm HG and le than 21 mm Hg, with or without topical anti-hypertenive therapy. After a mean follow-up wa 19.82 ± 8.35 month and 21.29 ± 6.42 month for the Ahmed valve and ECP group repectively (P = .04), there were no tatitically ignificant difference in the mean IOP of the two group (14.73 ± 6.44 mm v 14.07 ± 7.21 mm, repectively). There were ignificant difference between pre- and potoperative IOP for both group (P < .001). Kaplan-Meier urvival curve analyi howed a probability of ucce at 24 month of 70.59% and 73.53% for the Ahmed and ECP group, repectively (P = .7). Complication included choroidal detachment (Ahmed 17.64%, ECP 2.94%), hallow anterior chamber (Ahmed 17.64%, ECP 0%), and hyphema (Ahmed 14.7%, ECP 17.64%). The author conclude that Ahmed hunt implant and ECP have imilar ucce rate in the treatment of refractory glaucoma, but that the complication rate i lower with ECP