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Comparison between primary Ahmed valve implantation and primary trabeculectomy with mitomycin C in pseudophakic patients with exfoliative glaucoma

  • Glaucoma
  • Published:
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Abstract

Purpose

To compare the efficacy and safety of primary Ahmed valve implantation (AVI) and primary trabeculectomy with mitomycin C (MMC) in patients with pseudophakic exfoliative glaucoma (XFG).

Methods

All enrolled patients were divided into two groups: the TRAB group, comprising patients who underwent trabeculectomy with MMC, and the AVI group, comprising patients who underwent AVI. Intraocular pressure (IOP), mean deviation (MD), endothelial cell density of cornea (ECD), and the number of topical anti-glaucoma agents used during study period were retrospectively analyzed. Surgical success rates were compared between two groups using Kaplan–Meier survival analysis. Three levels of surgical success were defined as follows: (1) IOP ≤ 18 mmHg and an IOP reduction of 20% without medication; (2) IOP ≤ 15 mmHg and an IOP reduction of 25% without medication; and (3) IOP ≤ 18 mmHg and an IOP reduction of 20%, irrespective of medication.

Results

The TRAB and AVI groups comprised 40 and 36 patients, respectively. At 36 months postoperatively, IOP was 15.7 ± 2.8 mmHg in the TRAB group and 16.9 ± 3.3 mmHg in the AVI group (p = 0.140). Surgical success rates in the TRAB group were 47.5, 37.5, and 77.5% and those in the AVI group were 41.6, 33.3, and 75.0% at 36 months for surgical criteria 1, 2, and 3, respectively. There were no statistically significant differences in the success rates between the two groups. However, regarding surgical criteria 2, the success rate of the AVI group at 1 year was significantly better than that of the TRAB group (p = 0.030).

Conclusions

Primary AVI was not inferior to primary trabeculectomy with MMC in medically uncontrolled patients with XFG.

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Funding

This work was supported by the Dong-A University Research Fund.

The funders had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, Dong-A University, 26 Daesingongwon-Ro, Seo-Gu, Busan, 49201, Republic of Korea

    Su Yeong Hwang, Hee Bae Ahn & Sang Wook Jin

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  1. Su Yeong Hwang
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  2. Hee Bae Ahn
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Contributions

Design and conduct of the study: S.W. Jin, S.Y. Hwang, and H.B. Ahn. Data collection: S.Y. Hwang. Management, analysis, and interpretation of data and preparation of the manuscript: S.W. Jin, S.Y. Hwang, and H.B. Ahn. All authors reviewed the manuscript.

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Correspondence to Sang Wook Jin.

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All procedures performed involving human participants were in accordance with the ethical standards of Institutional Review Board of Dong-A University Hospital (DAUHIRB-23–114) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The requirement for informed consent was waived because of the study’s retrospective design.

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Hwang, S.Y., Ahn, H.B. & Jin, S.W. Comparison between primary Ahmed valve implantation and primary trabeculectomy with mitomycin C in pseudophakic patients with exfoliative glaucoma. Graefes Arch Clin Exp Ophthalmol 261, 3559–3567 (2023). https://doi.org/10.1007/s00417-023-06233-8

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  • DOI: https://doi.org/10.1007/s00417-023-06233-8

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