Hypertensive Phase Following Silicone Plate Ahmed Glaucoma Valve Implantation

To estimate the incidence of hypertensive phase (HP) following silicone plate Ahmed glaucoma valve implantation and to explore the risk factors for developing HP.

A total of 325 eyes from 325 patients who underwent Ahmed glaucoma valve implantation for uncontrolled intraocular pressure (IOP) and were followed for at least 1 year were included. The HP was defined as IOP>21 mm Hg (with or without IOP-lowering medication) during the first 3 months after surgery. Eyes were divided into HP and non-HP development groups. Overall success was defined as reaching an IOP>5 and <22 mm Hg with (qualified success) or without (complete success) use of an IOP-lowering medication. Risk factors associated with HP development were determined by logistic regression analysis.

Among 325 eyes, 101 eyes (31.1%) experienced HP. For 24 eyes (23.8%), HP had not resolved by postoperative year 1. The HP group showed a significantly higher mean preoperative IOP than the non-HP group (37.1 ± 11.4 vs. 32.3 ± 11.2 mm Hg, P=0.004). The overall success rate was not significantly different between groups (81.2%, HP group vs. 89.7%, non-HP group; P=0.111); however, the complete success rate was significantly higher in the non-HP group (26.7% vs. 43.3%, P=0.003) at postoperative year 1. HP development was positively associated with preoperative IOP (odds ratio, 1.025; P=0.023).

Higher preoperative IOP was associated with the HP development. The non-HP group achieved a higher complete success rate when assessed at postoperative year 1.