Risk factors for hypertensive phase after Ahmed glaucoma valve implantation

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Onur Özalp1, Serdar İlgüy2, Eray Atalay3

  • 1Ophthalmology Clinic, Devrek State Hospital, Zonguldak, Turkey.

International Ophthalmology
|August 22, 2021
PubMed

Insights

Half of patients experienced a hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation. Higher preoperative intraocular pressure and younger age were key risk factors for developing HP.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Intraocular Pressure Management

Background:

  • Ahmed glaucoma valve (AGV) implantation is a surgical option for refractory glaucoma.
  • Postoperative hypertensive phase (HP) is a potential complication following AGV implantation, necessitating careful monitoring.

Purpose of the Study:

  • To identify risk factors and clinical characteristics associated with the hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation.
  • To analyze the incidence and resolution patterns of HP in patients undergoing AGV surgery.

Main Methods:

  • Retrospective study of 60 eyes from 57 patients with at least 1-year follow-up after AGV implantation.
  • Hypertensive phase defined as intraocular pressure (IOP) > 21 mmHg within the first 3 months post-surgery.
  • Logistic regression analysis employed to determine independent risk factors for HP development.

Main Results:

  • Hypertensive phase (HP) occurred in 51.7% of eyes, with an average peak IOP of 27.6 mmHg.
  • HP resolved in 87.1% of affected eyes by the 3-month postoperative visit.
  • Independent risk factors for HP included preoperative IOP > 30 mmHg and younger age (≤64 years). Traumatic glaucoma showed the highest HP rate (83.3%).

Conclusions:

  • The hypertensive phase (HP) is a common occurrence after Ahmed glaucoma valve (AGV) implantation, affecting approximately half of the patients.
  • Elevated preoperative intraocular pressure and younger patient age are significant risk factors for developing HP.
  • While most cases of HP resolve by three months, affected eyes may require more intensive IOP-lowering management.
Abstract

Keywords:
Ahmed glaucoma valveGlaucomaHypertensive phaseRisk factors

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