Ahmed ClearPath vs. Baerveldt Glaucoma Implant: A Retrospective Noninferiority Comparative Study.

PURPOSE

To compare the efficacy and safety of 2 nonvalved glaucoma drainage devices (GDDs): Ahmed ClearPath (ACP) vs. Baerveldt glaucoma implant (BGI).

DESIGN

Single-center, retrospective, comparative study.

PARTICIPANTS

Consecutive patients who underwent ACP or BGI surgery for glaucoma (250 mmor 350 mmmodels), had ≥ 6 months of follow-up, and no prior GDD implantation.

METHODS

Chart review of ACP or BGI surgery in patients with glaucoma at Wills Eye Hospital (2020-2023).

MAIN OUTCOME MEASURES

The primary outcome measure was surgical failure at the end of follow-up, defined as intraocular pressure (IOP) > 21 or 21 mmHg (3/12, 25.0%), glaucoma reoperation (5/12, 41.7%), and tube removal (4/12, 33.3%). No eyes progressed to NLP vision. Kaplan-Meier survival analysis showed similar cumulative rate of surgical failure in both groups (P = 0.871). Both groups achieved significant IOP and medication reduction compared to their baseline. Final IOP, BCVA, and complication rates were similar in both groups, but medication number was significantly lower in the ACP group (P = 0.012). Both the 250 mmand 350 mmmodels had similar outcomes, but diplopia was significantly associated with the 350 mmmodel of either implant (P = 0.012). Univariate logistic regression analysis did not identify either tube type or plate size as predictors of surgical failure.

CONCLUSIONS

This study compares the recently approved ACP vs. BGI. Both implants had similar surgical failures and complication rates. Final IOP was similar in both groups, but ACP achieved lower medication number. Diplopia was significantly associated with the use of 350 mmmodel of either implant. Neither tube type nor plate size were significant predictors of surgical failure. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.