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Ophthalmology. 2011 Nov;118(11):2180-9. doi: 10.1016/j.ophtha.2011.05.004. Epub 2011 Sep 1.

The Ahmed Versus Baerveldt study: one-year treatment outcomes.

Author information

  • 1Department of Ophthalmology and Vision Sciences, University of Toronto, Faculty of Medicine, Toronto, Canada.

Abstract

OBJECTIVE:

To report the 1-year treatment outcomes of the Ahmed Versus Baerveldt (AVB) Study.

DESIGN:

Multicenter randomized clinical trial.

PARTICIPANTS:

A total of 238 patients were enrolled in the study, including 124 in the Ahmed group and 114 in the Baerveldt group.

METHODS:

Patients aged 18 years or older with uncontrolled glaucoma refractory to medicinal, laser, and surgical therapy were randomized to undergo implantation of an Ahmed-FP7 valve (New World Medical, Inc., Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc., Santa Ana, CA), to be followed for 5 years.

MAIN OUTCOME MEASURES:

The primary outcome measure was failure, defined as intraocular pressure (IOP) out of target range (5-18 mmHg with ≥ 20% reduction from baseline) for 2 consecutive visits after 3 months, vision-threatening complications, additional glaucoma procedures, or loss of light perception. Secondary outcome measures included IOP, medication use, visual acuity, complications, and interventions.

RESULTS:

There were no significant differences in baseline ocular or demographic characteristics between the study groups with the exception of sex. Preoperatively, the study group had a mean IOP of 31.4 ± 10.8 mmHg on a mean of 3.1 ± 1.0 glaucoma medications with a median Snellen acuity of 20/100. The cumulative probability of failure a 1-year was 43% in the Ahmed group and 28% in the Baerveldt group (P = 0.02). The mean IOP at 1 year was 16.5 ± 5.3 mmHg in the Ahmed group and 13.6 ± 4.8 mmHg in the Baerveldt group (P < 0.001). The mean number of glaucoma medications required was 1.6 ± 1.3 in the Ahmed group and 1.2 ± 1.3 in the Baerveldt group (P = 0.03). Visual acuity was similar in both groups at all visits in the first year (P = 0.66). In the first year after surgery, there were a similar number of patients who experienced postoperative complications in the 2 groups (45% Ahmed, 54% Baerveldt, P = 0.19), but a greater number of patients in the Baerveldt group required interventions (26% Ahmed vs. 42% Baerveldt, P = 0.009).

CONCLUSIONS:

The Baerveldt-350 group had a higher success rate than the Ahmed-FP7 group after 1 year of follow-up, but required a greater number of interventions.

FINANCIAL DISCLOSURE(S):

Proprietary or commercial disclosure may be found after the references.

Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PMID:
21889801
[PubMed - indexed for MEDLINE]
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