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Factors associated with vision loss in Black or Hispanic patients 1 year after standalone or combined Ahmed glaucoma valve surgery

  • Glaucoma
  • Published:
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 Abstract

Purpose

To determine factors associated with vision loss 1 year after Ahmed glaucoma valve (AGV) surgery in Black or Hispanic patients, who bear disproportionate glaucoma burdens yet have been underrepresented in pivotal trials.

Methods

This retrospective study included Black or Hispanic patients who received AGVs standalone or combined with phacoemulsification and/or cyclodestructive lasers. Univariate and multivariate generalized estimating equations evaluated the effects of baseline, surgical, and postoperative factors on vision loss of two Snellen lines or more at the 1-year follow-up visit. The primary term was the hypertensive phase (HP), which signified an intraocular pressure (IOP) reading > 21 mmHg within the first 3 postoperative months after reduction below 22 in the first week, without other tube malfunction.

Results

Of 241 eyes from 186 patients, vision loss of ≥ 2 lines at the 1-year follow-up visit occurred in 21.6% (N = 52). Vision loss of ≥ 2 lines occurred in 52.5% of eyes at week 1, 36.9% of eyes at month 1, and 27.0% of eyes at month 3. Between 6 months and 1 year, vision loss frequencies stabilized. In the multivariate model, HP (OR = 4.71 (2.14, 10.38)), total quadrants with split fixation (1.47 (1.20, 1.81)), follow-up non-glaucomatous eye pathology (2.89 (1.44, 5.80)), and concurrent cataract surgery (0.42 (0.22, 0.82)) each met significance (p < 0.05).

Conclusion

Post-AGV vision loss in the early follow-up period among Black or Hispanic patients was often transient. Hypertensive phase and split fixation each increased the odds of vision loss at 1 year, while concurrent cataract surgery decreased the odds.

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Authors and Affiliations

  1. College of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA

    Nicholas E. Tan & Shannon X. Chen

  2. Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA

    Nathan M. Radcliffe

  3. New York Eye Surgery Center, Bronx, NY, USA

    Nathan M. Radcliffe

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Correspondence to Nathan M. Radcliffe.

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Ethics approval

This research study was conducted retrospectively from data obtained for clinical purposes. An IRB official waiver of ethical approval was granted from the Sterling IRB. All research was performed in accordance with the Health Insurance Portability and Accountability Act of 1996 and adhered to tenets of the Declaration of Helsinki.

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The need for informed consent was waived owing to the retrospective study design.

Competing interests

This study was supported in part by an Alpha Omega Alpha Carolyn L Kuckein Student Research Fellowship. Author NMR reports the following: CATS LLC—Consultant (C). Allergan—C, Speaker (S). Alcon—C, S. Novartis—C, S. Ellex—C. Eyenovia—C. Lumenis—C. ELT Sight—C, Equity (E). Equinox—C, Investor (I). Iridex—C. Aerie—C, S. Bausch & Lomb/Valeant—C, S. BVI—C, S. Eyepoint—C. Ivantis—C, S. Glaukos—C, S. Alimera—C, S. Kala Lumenis Inc—C, S, New World Medical—C, S. SpyGlass—C. Sight Sciences—C, S. Santen, Inc—C. Thea—C. Reichert—C. Shire—C. Carl Zeiss Meditec—C. Ocular Science—C. Ocular Therapeutix—C. Omeros—C. Quantel Medical—C. ViaLase—C. The authors have no other competing interests to declare that are relevant to the content of this article.

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Preliminary data was presented at the Association for Research in Vision and Ophthalmology’s 2021 annual meeting under the title, “Combination of split fixation and hypertensive phase is associated with vision loss in Latino and Black patients following Ahmed Glaucoma Valve surgery.”.

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Tan, N.E., Chen, S.X. & Radcliffe, N.M. Factors associated with vision loss in Black or Hispanic patients 1 year after standalone or combined Ahmed glaucoma valve surgery. Graefes Arch Clin Exp Ophthalmol 260, 3565–3575 (2022). https://doi.org/10.1007/s00417-022-05804-5

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