Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

• Published in: PloS one 2020-11, Vol.15 (11), p.e0241886-e0241886
• Main Authors: Lee, Han Min, Park, Kee Sup, Jeon, Yoo Young, Kim, Woo Jin, Lee, Nam Ho, Kim, Kyoung Nam, Kim, Chang-Sik
• Format: Article
• Language: English
• Subjects: Aged; Biology and Life Sciences; Care and treatment; Cataracts; Complications; Cornea; Engineering and Technology; Eye; Eye surgery; Female; Fixation; Glaucoma; Glaucoma - physiopathology; Glaucoma - surgery; Glaucoma Drainage Implants; Hospitals; Humans; Hypertension; Implantation; Intraocular Pressure; Lasers; Male; Medical records; Medicine and Health Sciences; Methods; Middle Aged; Operative Time; Patient outcomes; Patients; Prosthesis Implantation - instrumentation; Retrospective Studies; Surgery; Surgical Fixation Devices; Surgical outcomes; Sutures; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241886

This study compared surgical outcomes between free plate Ahmed glaucoma valve (FPAGV) implantation without plate fixation and conventional Ahmed glaucoma valve (CAGV) implantation with plate fixation. A retrospective, comparative case series study. Patients with refractory glaucoma who underwent FPAGV or CAGV implantation and were followed >1 year were enrolled consecutively. We reviewed medical records, including data on postoperative intraocular pressure (IOP) and postoperative complications. The success rate and early postoperative hypertensive phase were compared between groups. A total of 74 patients with CAGV implantations and 36 patients with FPAGV implantations were studied. The average follow-up periods were 23.3 ± 2.6 months (CAGV) and 22.8 ± 2.8 months (FPAGV; p = 0.424). The surgery time was significantly shorter in the FPAGV group than in the CAGV group (42.6 ± 4.1 vs. 47.3 ± 5.4 min; p < 0.001). Postoperative IOP at 1 week and 1 month were significantly lower in the FPAGV group than in the CAGV group (11.8 ± 3.6 and 14.0 ± 5.3 mmHg vs. 18.7 ± 5.5 and 22.2 ± 5.2 mmHg; p = 0.012 and p = 0.002, respectively). An early postoperative hypertensive phase occurred in 62 eyes, and the frequency was greater in the CAGV group (50 eyes) than the FPAGV group (12 eyes; p = 0.001). There was no significant difference in postoperative complications between the two groups (p = 0.735). The success rate was 84.2% in the FPAGV group and 80.6% in the CAGV group 24 months after surgery (p = 0.367). FPAGV implantation was associated with a shorter surgery time, without any change in the extent of IOP reduction or complication rate. This procedure may be considered a good alternative for CAGV implantation in patients with refractory glaucoma.