Long-term outcome of low-cost glaucoma drainage device (Aurolab aqueous drainage implant) compared with Ahmed glaucoma valve.
Pandav Surinder Singh, Seth Natasha Gautam, Thattaruthody Faisal, Kaur Manpreet, Akella Madhuri, Vats Abhinav, Kaushik Sushmita, Raj Srishti
AI Summary
This study found the low-cost AADI device provided better long-term IOP control with fewer medications and re-surgeries than Ahmed valves, despite slightly more hypotony, offering a promising alternative for refractory glaucoma.
Abstract
Purpose
To compare the long-term outcome of Aurolab aqueous drainage device (AADI) and Ahmed glaucoma valve (AGV).
Method
Retrospective analysis of patients with refractory glaucoma who underwent AGV (AGV-FP7) and AADI (AADI Model 350) implantation. The outcome measures were intraocular pressure (IOP), requirement of antiglaucoma medications (AGMs) and re-surgery for IOP control. The postoperative complications were classified as early (≤3 months), intermediate (>3 months to ≤1 year) or late (>1 year).
Results
173 patients (189 eyes) underwent AGV implantation (AGV Group) while 201 patients (206 eyes) underwent AADI implantation (AADI group). The IOP in AADI group was significantly lower than AGV group at all time points till 2 years and comparable at 3 years. AADI group had significantly higher number of AGM in preoperative period and significantly lower number in postoperative period till 3 years compared with AGV group. AADI group had more hypotony-related complications but statistically insignificant (p = 0.07). The surgical interventions were significantly higher in AGV (n = 18) compared with AADI group (n = 5) in late postoperative period (p = 0.01). At 3 years, overall success was seen in 58.18% in AGV and 73.08% in AADI group (p = 0.15). Complete success was seen in 7.27% patients in AGV and 25.00% patients in AADI group (p = 0.02).
Conclusion
Both AADI and AGV implant had comparable mean IOP at 3 years with lesser requirement of AGM in the AADI group. Both procedures appear to be safe with slight preponderance of hypotony-related complications in AADI group.
MeSH Terms
Shields Classification
Key Concepts5
In a retrospective analysis of patients with refractory glaucoma, the intraocular pressure (IOP) in the Aurolab aqueous drainage device (AADI) group (201 patients, 206 eyes) was significantly lower than in the Ahmed glaucoma valve (AGV) group (173 patients, 189 eyes) at all time points until 2 years, and comparable at 3 years.
In a retrospective analysis of patients with refractory glaucoma, the Aurolab aqueous drainage device (AADI) group (201 patients, 206 eyes) had a significantly lower number of antiglaucoma medications (AGMs) in the postoperative period until 3 years compared with the Ahmed glaucoma valve (AGV) group (173 patients, 189 eyes).
In a retrospective analysis of patients with refractory glaucoma, the surgical interventions for intraocular pressure control were significantly higher in the Ahmed glaucoma valve (AGV) group (n = 18) compared with the Aurolab aqueous drainage device (AADI) group (n = 5) in the late postoperative period (p = 0.01).
In a retrospective analysis of patients with refractory glaucoma, at 3 years, the overall success rate was 58.18% in the Ahmed glaucoma valve (AGV) group and 73.08% in the Aurolab aqueous drainage device (AADI) group (p = 0.15).
In a retrospective analysis of patients with refractory glaucoma, at 3 years, the complete success rate was 7.27% in the Ahmed glaucoma valve (AGV) group and 25.00% in the Aurolab aqueous drainage device (AADI) group (p = 0.02).
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