Comparison of Silicone- and Porous-Plate Ahmed Glaucoma Valves

Abstract

Purpose

Our aim was to evaluate and compare the clinical outcomes after implantation of the silicone-plate (model FP7) and porous polyethylene-plate (model M4) Ahmed Glaucoma Valves.

Patients and Methods

This was a prospective, multicenter, comparative series. A total of 52 eyes (52 patients) were treated with either the silicone or porous plate Ahmed Glaucoma Valve implant. Hypertensive phase was defined as intraocular pressure >21 mmHg during the first 3 months postoperatively. Success was defined as 5 mmHg ≤intraocular pressure ≤21 mmHg (with or without additional glaucoma medications), without loss of light perception and without additional glaucoma procedures. Patients were monitored for 1 year after surgery.

Results

The pre-operative intraocular pressure was 29.9 ± 6.6 mmHg and 33.8 ± 10.5 in the silicone-plate and porous-plate groups, respectively (P = 0.118). At 12 months after surgery, the mean intraocular pressure was 13.6 ± 4.7 mmHg in the silicone-plate group and 17.9 ± 10.9 mmHg in the porous-plate group (P = 0.141). The mean number of glaucoma medications at 12 months was 1.64 ± 1.40 mmHg and 1.89 ± 1.54 mmHg in the silicone- and porous-plate groups, respectively (P = 0.605). Hypertensive phase was not significantly different in the two groups (50.0% of the silicone-plate and 57.7% of the porous-plate groups, P = 0.578). At 12 months after surgery, the percent success for the silicone-plate and porous-plate groups was 88.5% and 53.8%, respectively (P = 0.005). Complications were similar in the two groups.

Conclusion

The porous-plate Ahmed Glaucoma Valve showed similar average intraocular pressure reduction compared with the silicone-plate model. At 12 months after surgery, there was a significantly lower success rate in the porous-plate compared with the silicone-plate group.

Keywords:

• Ahmed Glaucoma Valve
• model FP7
• model M4
• glaucoma drainage implant
• porous polyethylene
• Medpor

Acknowledgments

Ahmed Glaucoma Devices were provided by New World Medical (Rancho Cucamonga, CA) for study implantation. There was no financial grant support provided for this investigator-initiated study. No company wrote or influenced the wording of the manuscript. Clinical trial registration (http://clinicaltrials.gov) identifier NCT01883856, with the study start date listed as the date of IRB approval at the sponsoring institution (University of Virginia) and the submission (registration) date listed after completion of IRB approval and site training completion of the other sites in this multicenter study.

Disclosure

Dr. Roa and Dr. Netland have no proprietary interest or conflict of interest related to the devices described in this study. Dr Costa received personal fees from Alcon and Iridex; grants, personal fees from Allergan, outside the submitted work. Dr. Sarkisian received grant support from and/or was a consultant/advisor for Alcon, Allergan, Bausch & Lomb, Beaver-Visitec International, Inc., Katena Products, Inc, Ocular Science, Omeros, Santen, Inc., Sight Sciences, and Glaukos; consulting fees from New World Medical, Alcon, Sight Sciences, and Glaukos; speaker honoraria from Alcon; and has equity ownership in Sight Sciences and Ocular Science, unrelated to this work. Dr Al-Aswad reports grants from New World Medical, during the conduct of the study; grants from Topcon, owns shares from Globechek, and personal fees from Aries and Topcon, outside the submitted work. Dr. Ahmed received consulting fees from Alcon, Allergan, New World Medical, and Glaukos; and speaker honoraria from Alcon, Allergan, and New World Medical. Dr. Moster received consulting fees from Alcon, Allergan, Bausch and Lomb, Glaukos, Aerie, and Qura; and speaker honoraria from Alcon, Allergan, Aerie, and Bausch and Lomb. The authors report no other conflicts of interest in this work.