Kandarakis Stylianos A, Petrou Petros, Katsimpris Andreas, Papakonstantinou Evangelia, Timpilis Marios, Chronopoulou Konstantina, Lehman Amanda, Ifantides Cristos, Georgalas Ilias
Department of Ophthalmology, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital, Athens, Greece.
Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA.
J Glaucoma. 2023 Jan 1;32(1):27-33. doi: 10.1097/IJG.0000000000002129. Epub 2022 Sep 27.
Ahmed Valve and Baerveldt shunt are efficacious options in vitrectomized eyes. Baerveldt implant achieves a lower mean intraocular pressure (IOP) at 2 years, with fewer medications and a higher percentage of medication-free patients.
To investigate and compare the efficacy and complications between Ahmed FP7 Glaucoma Valve (AGV) and Baerveldt 101-350 Glaucoma Implant (BGI) in vitrectomized eyes.
In this single-center randomized clinical trial, 43 vitrectomized eyes (39 patients) underwent glaucoma drainage device implantation. Eyes were randomized to receive either an AGV (FP7) or a BGI (101-350) and were followed for 2 years. Surgical success was defined as an IOP measurement≤18 mm Hg and≥5 mm Hg with or without glaucoma medication at 2 or more sequential visits after 3 months. The primary outcome was the comparison of the success rate at 2 years, while mean IOP, mean number of medications, and number of complications were considered secondary outcomes.
Kaplan-Meier estimates of the 2-year success rates in IOP control after GDD implantation were similar between the 2 groups; AGV group 81.8% (95% CI: 67.2%-99.6%) and BGI group 85.7% (95% CI: 72.0%-100.0%), (log-rank test P value = 0.74). Patients in the BGI group had a statistically significant lower mean IOP compared with the AGV group in all follow-up visits at 2, 6, 12, and 24 months (11.62 vs. 17.45 mm Hg at the latter P value <0.001). The BGI group required a significantly lower number of medications for IOP control at the 2-year visit compared with the AGV group (0.76±0.99 vs. 1.5±1.06 P value = 0.02) but had a higher number of complications (62% vs. 41%, respectively).
GDDs provide a viable solution for IOP control in vitrectomized eyes. Based on our prospective comparison, both Ahmed FP7 Glaucoma Valve and Baerveldt 101-350 Glaucoma Implant are efficacious options.
在接受玻璃体切割术的眼中，艾哈迈德瓣膜和贝尔维尔德分流术是有效的选择。贝尔维尔德植入物在2年时可实现更低的平均眼压（IOP），用药更少，且无药患者的比例更高。
研究并比较艾哈迈德FP7青光眼瓣膜（AGV）和贝尔维尔德101-350青光眼植入物（BGI）在接受玻璃体切割术的眼中的疗效和并发症。
在这项单中心随机临床试验中，43只接受玻璃体切割术的眼睛（39例患者）接受了青光眼引流装置植入。将眼睛随机分为接受AGV（FP7）或BGI（101-350），并随访2年。手术成功定义为在3个月后的2次或更多次连续随访中，无论是否使用青光眼药物，眼压测量值≤18 mmHg且≥5 mmHg。主要结局是比较2年时的成功率，而平均眼压、平均用药次数和并发症数量被视为次要结局。
两组在青光眼引流装置植入后2年眼压控制成功率的Kaplan-Meier估计值相似；AGV组为81.8%（95%CI：67.2%-99.6%），BGI组为85.7%（95%CI：72.0%-100.0%），（对数秩检验P值=0.74）。在2、6、12和24个月的所有随访中，BGI组患者的平均眼压与AGV组相比在统计学上显著更低（后者为11.62 vs. 17.45 mmHg，P值<0.001）。与AGV组相比，BGI组在2年随访时控制眼压所需的药物数量显著更少（0.76±0.99 vs. 1.5±1.06，P值=0.02），但并发症数量更多（分别为62%和41%）。
青光眼引流装置为控制接受玻璃体切割术的眼睛的眼压提供了可行的解决方案。基于我们的前瞻性比较，艾哈迈德FP7青光眼瓣膜和贝尔维尔德101-350青光眼植入物都是有效的选择。
