García-Bardera Javier, Garcia-Bermúdez Mireia, Robles-Amor Patricia, Morales-Fernandez Laura, Martinez-de-la-Casa José M, Garcia-Feijoo Julián
Ophthalmology Unit, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Hospital Clinico San Carlos, Profesor Martin Lagos SN, 28040, Madrid, Spain.
Hospital Universitario Quironsalud Madrid, Madrid, Spain.
Int Ophthalmol. 2025 Jul 11;45(1):286. doi: 10.1007/s10792-025-03668-2.
To analyze the trend in Ahmed glaucoma valve (AGV) utilization in recent years and to assess its current clinical profile and surgical indications in glaucoma management.
A retrospective observational study was conducted at a tertiary hospital within the Spanish National Health System, evaluating AGV surgeries performed from 2010 to 2022. To characterize current AGV use, a subset of 156 eyes that underwent surgery in the past five years was analyzed. Clinical variables, including age, gender, glaucoma type, intraocular pressure (IOP), IOP-lowering medications, and visual field status, were collected from patients aged ≥ 18 years. Temporal trends, surgical indications, and their evolution were examined.
A total of 519 AGV implantations were included. AGV utilization increased from 15.2% of all glaucoma surgeries in 2010 to 27.5% in 2019 but significantly declined thereafter, reaching 6.9% in 2022 (p = 0.001). Among the 156 eyes in the recent subset, 93 had refractory glaucoma, which showed the most pronounced decline in AGV procedures and the poorest surgical outcomes. Eyes with sulcus-placed or aphakic lenses, uveitis, or neovascular glaucoma experienced a less marked reduction in AGV implantation rates. These cases presented with higher baseline IOP but exhibited less glaucomatous damage and a better response to AGV implantation.
AGV implantation has significantly declined over the past five years, particularly in refractory glaucoma. This trend may be attributed to the increased adoption of subconjunctival bleb-forming surgeries and to the impact of the COVID-19 pandemic. Despite this overall decline, AGV continues to be primarily employed in cases of secondary glaucoma.
分析近年来艾哈迈德青光眼阀（AGV）的使用趋势，并评估其在青光眼治疗中的当前临床特征和手术指征。
在西班牙国家卫生系统的一家三级医院进行了一项回顾性观察研究，评估2010年至2022年期间进行的AGV手术。为了描述当前AGV的使用情况，分析了过去五年接受手术的156只眼睛的子集。从年龄≥18岁的患者中收集临床变量，包括年龄、性别、青光眼类型、眼压（IOP）、降低眼压的药物和视野状态。研究了时间趋势、手术指征及其演变。
共纳入519例AGV植入术。AGV的使用率从2010年所有青光眼手术的15.2%增加到2019年的27.5%，但此后显著下降，2022年降至6.9%（p = 0.001）。在最近的子集中的156只眼睛中，93只患有难治性青光眼，其AGV手术的下降最为明显，手术效果最差。植入沟内或无晶状体的眼睛、葡萄膜炎或新生血管性青光眼的AGV植入率下降不太明显。这些病例的基线眼压较高，但青光眼损害较轻，对AGV植入的反应较好。
在过去五年中，AGV植入术显著下降，尤其是在难治性青光眼中。这种趋势可能归因于结膜下滤过泡形成手术的采用增加以及COVID-19大流行的影响。尽管总体下降，但AGV仍然主要用于继发性青光眼病例。
