Clinical Observation Of Ahmed Glaucoma Valve In The Treatment Of Refractory Glaucoma

Objective: To observe the clinical effect of Ahmed Glaucoma Valve implantation for refractory glaucoma.Methods: The clinical data of 145 patients(145 eyes)with refractory glaucoma who underwent AGV implantation in our hospital from February 2012 to November 2017 were retrospectively analyzed.The visual acuity,intraocular pressure(IOP),antiglaucoma medications,surgical success rate and postoperative complications were observed 1 day,3 days,1 month,3months,6 months and 12 months after operation.Results: There was no significant difference between preoperative visual acuity and postoperative visual acuity at 12 months(Z=-0.794,P=0.427).The preoperative IOP was(43.08±11.73)mmHg(1mmHg=0.133kpa),the IOP was(14.44 ±8.03),(12.79 ±5.26),(13.72 ±2.51),(14.19 ±2.85),(14.28 ±3.12),(14.66 ±3.37)mmHg at 1 day,3 days,1 month,3 months,6 months and 12 months after the surgery significantly.Compared with preoperative,the IOP decreased significantly at 1 day,3 days,1 month,3 months,6 months and 12 months after operation(P <0.001).The average numbers of antiglaucoma medications were(3.65 ±0.56)before operation,and(0.43±0.73),(0.39±0.70),(0.46±0.76),(0.55±0.79)at 1 month,3 months,6 months and 12 months after operation,respectively.Compared with preoperative,the numbers of antiglaucoma medications were significantly decreased at 1 month,3 months,6 months and 12 months after operation(P < 0.001).The total cumulative success rate was 96.55%,92.41%,85.52%,78.62%at 1 month,3 months,6 months and 12 months after operation,respectively,while the complete cumulative success rates were 69.66%,64.83%,56.55%,46.90%,respectively.There were 46 eyes with complications in the early postoperative period,including hyphema,shallow anterior chamber,hypotony and drainage tube obstruction,there were 19 eyes with complications in the late stage,including encapsulated cyst formation,tube exposure and corneal endothelial decompensation,all of them were relieved by drug or surgery.Conclusion: Ahmed Glaucoma Valve implantation is a safe and effective method for the treatment of refractory glaucoma.The success rate of AGV implantation in neovascular glaucomais low.