Intraoperative Triamcinolone Acetonide Injection During Ahmed Glaucoma Valve Surgery Suppresses the Occurrence of the...

Intraoperative sub-plate injection of triamcinolone acetonide during Ahmed glaucoma valve implantation markedly reduced the incidence of the postoperative hypertensive phase without increasing complications.

The objective of this study was to evaluate whether intraoperative sub-plate injection of triamcinolone acetonide (TA) during Ahmed glaucoma valve (AGV) implantation reduces postoperative hypertensive phase (HP) incidence.

We included 182 eyes from 182 patients who underwent AGV implantation between June 2017 and December 2023 at five institutions in Japan and were followed for a minimum of 3 months. The eyes were divided into two groups: 103 eyes received intraoperative sub-plate TA injection (TA group), and 79 eyes did not (non-TA group). The HP was defined as an initial intraocular pressure reduction to ≤22 mm Hg within 1 week postoperatively, followed by an increase to >21 mm Hg on two or more occasions within 3 months. Fisher's exact test,nonparametric tests, and multivariate logistic regression were used for statistical analyses.

HP occurred in 8 (7.8%) and 28 (35.4%) eyes in TA and non-TA groups, respectively (P<0.0001). Among the eyes with anterior chamber tube placement, no cases of HP were observed in the TA group, whereas 8 cases occurred in the non-TA group (P<0.0001). In pars plana cases, HP developed in 8 and 20 eyes in the TA and non-TA groups, respectively (P=0.016). Multivariate logistic regression analysis identified the absence of intraoperative TA injection as an independent risk factor for the HP (odds ratio: 0.16, P<0.0001).

Intraoperative sub-plate TA injection may be associated with a reduced incidence of postoperative HP after AGV implantation.