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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: Jun 15, 2025

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Failed Ahmed glaucoma valves: trabeculectomy versus repeat shunt surgery.

Neda Einollahi1,2, Azadeh Doozandeh1,2, Farideh Sharifipour1,2

  • 1Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

BMC Ophthalmology
|August 23, 2024
PubMed
Summary

Trabeculectomy (TRAB) offers better outcomes than repeat Ahmed glaucoma valve (re-AGV) surgery for failed glaucoma implants. TRAB achieved significantly lower intraocular pressure and higher success rates, reducing the need for medications.

Keywords:
Ahmed glaucoma valveFailureGlaucomaTrabeculectomy

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Surgical Outcomes

Background:

  • Ahmed glaucoma valve (AGV) implantation is a common treatment for refractory glaucoma.
  • Failure of AGV implants necessitates further surgical intervention.
  • Evaluating alternative surgical strategies for AGV failure is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the efficacy and safety of trabeculectomy (TRAB) versus repeat Ahmed glaucoma valve (re-AGV) implantation in patients with prior AGV failure.
  • To assess intraocular pressure (IOP) reduction and surgical success rates between the two surgical approaches.

Main Methods:

  • A quasi-experimental study involving 48 patients with failed AGV implants.
  • Patients underwent either TRAB with mitomycin C or re-AGV implantation.
  • Surgical success was evaluated based on predefined IOP targets and percentage reductions from baseline.

Main Results:

  • Trabeculectomy demonstrated a significantly higher cumulative probability of survival at one year compared to re-AGV, particularly with stricter success criteria.
  • Both procedures significantly reduced IOP postoperatively, with TRAB achieving lower IOP levels beyond one month.
  • Significantly fewer TRAB eyes (5%) required glaucoma medications at 12 months compared to re-AGV eyes (48%).

Conclusions:

  • Trabeculectomy is a safe and effective alternative for managing failed AGV implants.
  • TRAB leads to superior IOP control and higher success rates compared to repeat AGV implantation in selected patients.
  • These findings support considering TRAB as a primary surgical option in cases of AGV failure.