Ahmed Valve vs Baerveldt Tube implantation in Uveitic Glaucoma

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma II: Surgery / Glaucome II: Chirurgical
When: 5/31/2024, 02:00 PM - 03:30 PM
Where: Room | Salle 801

Abstract

Purpose: To compare the safety and efficacy of Ahmed (AI) and Baerveldt (BVT) drainage device implantion in uveitic glaucoma treatment.

Study design: Retrospective comparative study                                                              

Methods: Patients with uveitic glaucoma that underwent Ahmed or Baerveldt valve implantation between 2007 and 2020 in a single tertiary academic referral center were included. Patients were followed for over a year and intraocular pressure (IOP) had to be over 21mmHg on maximal medical treatment. Treatment success was defined as post-operative IOP < 21mmHg with or without drops and IOP reduction of ≥ 20 mmHg. Failure was defined as post-operative IOP > 21mmHg or IOP < 5 mmHg, need of another surgery and decreased vision to no light perception. 

Results: In total, 161 patients with uveitic glaucoma were reviewed. 101 patients received an AI and 61 patients received a BVT. Mean age was 56.08 (SD 19) years old in the AI group, and 63.81 (SD 13.66) years old in the BVT group (P-value = 0.0339). Other baseline characteristics were similar in both groups. Chronic anterior uveitis was the most frequent diagnosis. Mean change in best corrected visual acuity (BCVA) was similar in both groups (P-value = 0.8171). Mean post-operative IOP was of 13.5 mmHg AI, and 11 mmHg BVT (P-value = 0.0341) at one year of follow-up (FU); and 13.11mmHg AI and 9.89mmHg BVT (P-value = 0.0117) at two-year FU. IOP reduction was similar in both groups (P-value = 0.4933), as well as the mean number of drops (P-value = 0.5970). Success rates were higher in the BVT group (81.1% BVT vs 74.6% AI), but the difference was not statistically significant. Hypotonia rates were 15.4% and 28.5% in AI and BVT groups, respectively (P-value = 0.2166). More complications were observed in the BVT group, the difference was not significant (P-value = 0.0744).

Conclusion: Both implants seem to offer similar results in uveitic glaucoma. BVT implant tends towards better success rates, but also more complications, specifically hypotony, requiring reintervention. This study presents further clarity on the risks and benefits of surgical management in patients with uveitic glaucoma, which can guide therapeutic treatment options.

Presenter(s)

Presenting Author: Reinemary Michael

Additional Author(s):

Valeria Kheir, Université Laval

Catherine Baril, Université Laval

Béatrice Desmarchais, Université Laval

Caroline Lajoie, Université Laval

Annie Goyette, Université Laval

Jing Wang, Université Laval

Andrew Toren, Université Laval

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