Related Experiment Video
Updated: Jun 18, 2026
Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation
Published on: March 12, 2016
Ahmed and baerveldt in glaucoma surgery: what is the safest choice? - a systematic review and meta-analysis
Francesco Matarazzo1,2, Maria Laura Passaro3,4, Michele Rinaldi1
1Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy.
Insights
The Ahmed glaucoma valve (AGV) shows fewer hypotony complications than the Baerveldt glaucoma implant (BGI). Personalized device choice is key for successful glaucoma surgery outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Surgical Devices
Background:
- Glaucoma drainage devices (GDDs) are vital for complex glaucoma cases.
- The Ahmed glaucoma valve (AGV) and Baerveldt glaucoma implant (BGI) are the most frequently used GDDs.
- Evaluating complications, especially post-operative hypotony, is crucial for these devices.
Purpose of the Study:
- To compare the complication profiles of the AGV and BGI.
- Specifically evaluate the incidence of post-operative hypotony associated with each device.
- Assess secondary complications including vision loss and need for further surgery.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and non-randomized studies (NRSs).
- Included studies compared AGV and BGI in glaucoma patients.
- Primary outcome: persistent hypotony (IOP < 5 mmHg); secondary outcomes: various complications.
Main Results:
- AGV demonstrated lower rates of persistent hypotony (0.6% vs. 4.4%), choroidal effusion, vision loss, and cystoid macular edema compared to BGI in RCTs.
- BGI showed a lower requirement for additional surgery for IOP control (7.5% vs. 14.5%) in RCTs.
- No significant differences were observed in rates of suprachoroidal hemorrhage, corneal decompensation, or tube-related issues.
Conclusions:
- The Ahmed glaucoma valve (AGV) appears to have a safer profile regarding hypotony-related complications compared to the Baerveldt glaucoma implant (BGI).
- Individualized selection of glaucoma drainage devices is essential for optimizing surgical results.
- Further high-quality research is necessary to confirm these findings.
Background/Aims:
Glaucoma drainage devices (GDDs) are essential in managing complex glaucoma cases. This review focuses on the Ahmed glaucoma valve (AGV) and Baerveldt glaucoma implant (BGI), the most commonly used GDDs. We aim to evaluate complications associated with AGV and BGI, particularly post-operative hypotony.
Methods:
We systematically reviewed randomized controlled trials (RCTs) and non-randomized studies (NRSs) comparing AGV and BGI. The primary outcome was persistent hypotony (IOP < 5 mmHg). Secondary outcomes included hypotony maculopathy, choroidal effusion, suprachoroidal hemorrhage, vision loss, cystoid macular edema, diplopia, corneal decompensation, endophthalmitis, hyphema, further surgery for IOP control, tube interventions, exposure, and occlusion.
Results:
Thirteen studies (4 RCTs, 9 NRSs) with 2,513 eyes were analyzed. AGV was associated with a lower incidence of persistent hypotony in RCTs (0.6% vs. 4.4%, p = 0.006), choroidal effusion (4.95% vs. 15.8%, p < 0.0001), vision loss (9% vs. 18.9%, p = 0.01), and cystoid macular edema (2.5% vs. 9.6%, p = 0.009). BGI showed a lower need for further surgery to control IOP in RCTs (14.5% vs. 7.5%, p = 0.01). No significant differences were found for other outcomes, including suprachoroidal hemorrhage, corneal decompensation, and tube-related complications.
Conclusion:
AGV seems to offers a safer profile with fewer hypotony-related complications compared to BGI. Personalized device selection is crucial for optimizing glaucoma surgery outcomes. Further high-quality, well-designed studies are needed to validate those results.
Related Concept Videos
01:25Glaucoma: Overview
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment