Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Ophthalmol. 2018 Nov;66(11):1580-1585. doi: 10.4103/ijo.IJO_427_18.
To study the efficacy of the Aurolab aqueous drainage implant (AADI) compared to Ahmed glaucoma valve (AGV) in patients with refractory glaucoma.
This was a prospective, randomized controlled trial. Thirty-eight adult patients (>18 years) scheduled for a glaucoma drainage device (GDD) were randomized into two groups to receive either AGV or AADI. Primary outcome measures: intraocular pressure (IOP) control and requirement of antiglaucoma medications; secondary outcome measures: final best correct visual acuity (log MAR), visual field (Visual field index [VFI], mean deviation [MD] and pattern standard deviation [PSD]), postoperative complications and additional interventions. Complete success was defined as IOP ≥5-≤18 mmHg without antiglaucoma medications/laser/additional glaucoma surgery or any vision threatening complications.
There were 19 age and sex-matched patients in each group. Both groups had comparable IOP before surgery (P = 0.61). The AGV group had significantly lower IOP compared to AADI group (7.05 ± 4.22 mmHg vs 17.90 ± 10.32 mmHg, P = <0.001) at 1 week. The mean postoperative IOP at 6 months was not significantly different in the two groups (13.3 ± 4.2 and 11.4 ± 6.8 mmHg respectively; P = 0.48). At 6 months, complete success rate according to antiglaucoma medication criteria was 78.94% in AADI and 47.36% in AGV groups. AGV group required 1.83 times more number of topical medications than AADI group. There was no significant difference in early (P = 0.75) and late (P = 0.71) postoperative complications in the AADI and AGV group. The complete success rate was higher in AADI group (68.42%) than AGV group (26.31%) (P = 0.034).
In this study, AADI appears to have comparable efficacy versus AGV implant with higher complete success rate at 6 months follow-up.
研究金葡素眼内引流植入物（AADI）与 Ahmed 青光眼阀（AGV）在难治性青光眼患者中的疗效比较。
这是一项前瞻性、随机对照试验。38 例成年（>18 岁）患者计划接受青光眼引流装置（GDD）治疗，随机分为两组，分别接受 AGV 或 AADI 治疗。主要观察指标：眼压（IOP）控制和抗青光眼药物的需求；次要观察指标：最终最佳矫正视力（logMAR）、视野（视野指数[VFI]、平均偏差[MD]和模式标准差[PSD]）、术后并发症和额外干预。完全成功定义为 IOP≥5-≤18mmHg，无需抗青光眼药物/激光/额外青光眼手术或任何威胁视力的并发症。
两组各有 19 例年龄和性别匹配的患者。两组患者术前的 IOP 无显著差异（P=0.61）。AGV 组的 IOP 显著低于 AADI 组（术后 1 周时分别为 7.05±4.22mmHg 和 17.90±10.32mmHg，P＜0.001）。两组患者术后 6 个月的平均 IOP 无显著差异（分别为 13.3±4.2mmHg 和 11.4±6.8mmHg；P=0.48）。根据抗青光眼药物标准，术后 6 个月时，AADI 组的完全成功率为 78.94%，AGV 组为 47.36%。AGV 组需要的局部药物数量比 AADI 组多 1.83 倍。AADI 组和 AGV 组的早期（P=0.75）和晚期（P=0.71）术后并发症无显著差异。AADI 组的完全成功率（68.42%）高于 AGV 组（26.31%）（P=0.034）。
在这项研究中，AADI 与 AGV 植入物的疗效相当，但在 6 个月的随访中，其完全成功率更高。
