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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2015

Open Access 01-12-2015 | Research article

Comparison of the Ahmed glaucoma valve with the Baerveldt glaucoma implant: a meta-analysis

Authors: Yi-Wen Wang, Ping-Bao Wang, Chao Zeng, Xiao-Bo Xia

Published in: BMC Ophthalmology | Issue 1/2015

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Abstract

Background

This study aims to compare the efficacy and safety of the Ahmed glaucoma valve (AGV) with the Baerveldt glaucoma implant (BGI) in glaucoma patients.

Methods

Databases were searched to identify studies that met pre-stated inclusion criteria, involving randomized controlled clinical trials (RCTs) and non-randomized controlled clinical trials. Treatment effect was analyzed using a random-effect model.

Results

Ten controlled clinical trials (1048 eyes) were analyzed, involving two RCTs and eight retrospective comparative studies. Short-term results (6–18 months) and long-term results (>18 months) were analyzed separately. There was no significant difference in the success rate for short-term follow-up between the AGV and BGI groups (5studies, 714 eyes, odds ratio [OR]: 0.97; 95 % confidence interval [CI]: 0.56, 1.66; P = 0.90). For long-term pooled results (7studies, 835 eyes), the success rate of AGVs was lower than that of BGIs (OR: 0.73; 95 % CI: 0.54, 0.99, P = 0.04), However, subgroup and sensitivity analyses did not show a significant difference in the success rate between the two groups (P ≥0.05). The AGV group had a higher mean intraocular pressure than the BGI group in short-term (6 studies, 685 eyes, weighted mean difference [WMD]: 2.12 mmHg; 95 % CI: 0.72–3.52; P <0.05) and long-term pooled results (7 studies, 659 eyes, WMD: 1.85 mmHg; 95 % CI: 0.43, 3.28; P = 0.01). The BGI group required fewer glaucoma medications after implantation than the AGV group in two follow-up periods (all P <0.05). The AGV was found to be associated with a significantly lower frequency of total complications (8 studies, 971 eyes, OR: 0.67; 95 % CI: 0.50–0.90; P = 0.007) and severe complications (8 studies, 971 eyes, OR: 0.57; 95 % CI: 0.36–0.91; P = 0.02) than the BGI.

Conclusions

The study showed no significant difference in success rate between the two groups. The BGI was more effective for control of intraocular pressure and required fewer medications than the AGV, but the AGV had lower incidence of total and severe complications than the BGI.
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Literature
1.
Allen RC, Bellows AR, Hutchinson RT, Murphy SD. Filtration surgery in the treatment of neovascular glaucoma. Ophthalmology. 1982;89:1181–9.CrossRefPubMed
2.
Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Treatment outcomes in the Tube Versus Trabeculectomy (TVT) Study after five years of follow-up. Am J Ophthalmol. 2012;153:789–803.CrossRefPubMedPubMedCentral
3.
4.
Francis BA, Cortes A, Chen J, Alvarado JA. Characteristics of glaucoma drainage implants during dynamic and teady-state flow conditions. Ophthalmology. 1998;105:1708–14.CrossRefPubMed
5.
Huang MC, Netland PA, Coleman AL, Siegner SW, Moster MR, Hill RA. Intermediate-term clinical experience with the Ahmed Glaucoma Valve implant. Am J Ophthalmol. 1999;127:27–33.CrossRefPubMed
6.
Patel S, Pasquale LR. Glaucoma drainage devices: a review of the past, present, and future. Semin Ophthalmol. 2010;25:265–70.CrossRefPubMed
7.
Budenz DL, Barton K, Gedde SJ, Feuer WJ, Schiffman J, Costa VP, et al. Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2015;122:308–16.CrossRefPubMed
8.
Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 (updated March 2011). Cochrane Collaboration 2011. Available from:www.​cochrane-handbook.​org. Accessed Feb 05, 2015.
9.
Liu JP. Method of systematic reviews in nonrandomized study (1). Chinese J Evid Based Med. 2001;1:239–43.
10.
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64:383–94.CrossRefPubMed
11.
Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.CrossRefPubMed
12.
Christakis PG, Tsai JC, Kalenak JW, Zurakowski D, Cantor LB, Kammer JA, et al. The Ahmed versus Baerveldt study: three-year treatment outcomes. Ophthalmology. 2013;120:2232–40.CrossRefPubMed
13.
El Gendy NM, Song JC. Long term comparison between single stage Baerveldt and Ahmed glaucoma implants in pediatric glaucoma. Saudi J Ophthalmol. 2012;26:323–6.CrossRefPubMedPubMedCentral
14.
Goulet 3rd RJ, Phan AD, Cantor LB, WuDunn D. Efficacy of the Ahmed S2 glaucoma valve compared with the Baerveldt 250-mm2 glaucoma implant. Ophthalmology. 2008;115:1141–7.CrossRefPubMed
15.
Tsai JC, Johnson CC, Kammer JA, Dietrich MS. The Ahmed shunt versus the Baerveldt shunt for refractory glaucoma II: longer-term outcomes from a single surgeon. Ophthalmology. 2006;113:913–7.CrossRefPubMed
16.
Tesser R, Hess DB, Freedman SF. Combined intraocular lens implantation and glaucoma implant (tube shunt) surgery in pediatric patients: a case series. JAAPOS. 2005;9:330–5.
17.
Chung AN, Aung T, Wang JC, Chew PT. Surgical outcomes of combined phacoemulsification and glaucoma drainage implant surgery for Asian patients with refractory glaucoma with cataract. Am J Ophthalmol. 2004;137:294–300.CrossRefPubMed
18.
Syed HM, Law SK, Nam SH, Li G, Caprioli J, Coleman A. Baerveldt-350 implant versus Ahmed valve for refractory glaucoma: a case-controlled comparison. J Glaucoma. 2004;13:38–45.CrossRefPubMed
19.
Wang JC, See JL, Chew PT. Experience with the use of Baerveldt and Ahmed glaucoma drainage implants in an Asian population. Ophthalmology. 2004;111:1383–8.CrossRefPubMed
20.
Beck AD, Freedman S, Kammer J, Jin J. Aqueous shunt devices compared with trabeculectomy with Mitomycin-C for children in the first two years of life. Am J Ophthalmol. 2003;136:994–1000.CrossRefPubMed
21.
Budenz DL, Barton K, Feuer WJ, Schiffman J, Costa VP, Godfrey DG, et al. Treatment outcomes in the Ahmed Baerveldt Comparison Study after 1 year of follow-up. Ophthalmology. 2011;118:443–52.CrossRefPubMed
22.
Barton K, Feuer WJ, Budenz DL, Schiffman J, Costa VP, Godfrey DG, et al. Three-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2014;121:1547–57. e1.CrossRefPubMedPubMedCentral
23.
The Advanced Glaucoma Intervention Study (AGIS) Investigators. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:429–40.CrossRef
24.
Heuer DK, Lloyd MA, Abrams DA, Baerveldt G, Minckler DS, Lee MB, et al. Which is better? One or two? A randomized clinical trial of single-plate versus double-plate Molteno implantation for glaucomas in aphakia and pseudophakia. Ophthalmology. 1992;99:1512–9.CrossRefPubMed
25.
Britt MT, LaBree LD, Lloyd MA, Minckler DS, Heuer DK, Baerveldt G, et al. Randomized clinical trial of the 350-mm2 versus the 500-mm2 Baerveldt implant: longer term results: is bigger better? Ophthalmology. 1999;106:2312–8.CrossRefPubMed
26.
Pan T, Stay MS, Barocas VH, Brown JD, Ziaie B. Modeling and characterization of a valved glaucoma drainage device with implications for enhanced therapeutic efficacy. IEEE Trans Biomed Eng. 2005;52:948–51.CrossRefPubMed
27.
Mackenzie PJ, Schertzer RM, Isbister CM. Comparison of silicone and polypropylene Ahmed glaucoma valves: two-year follow-up. Can J Ophthalmol. 2007;42:227–32.CrossRefPubMed
28.
Law SK, Nguyen A, Coleman AL, Caprioli J. Comparison of safety and efficacy between silicone and polypropylene Ahmed glaucoma valves in refractory glaucoma. Ophthalmology. 2005;112:1514–20.CrossRefPubMed
29.
Brasil MV, Rockwood EJ, Smith SD. Comparison of silicone and polypropylene Ahmed Glaucoma Valve implants. J Glaucoma. 2007;16:36–41.CrossRefPubMed
30.
Ishida K, Netland PA, Costa VP, Shiroma L, Khan B, Ahmed II. Comparison of polypropylene and silicone Ahmed Glaucoma Valves. Ophthalmology. 2006;113:1320–6.CrossRefPubMed
31.
Allan EJ, Khaimi MA, Jones JM, Ding K, Skuta GL. Long-term efficacy of the Baerveldt 250 mm2 compared with the Baerveldt 350 mm2 implant. Ophthalmology. 2015;122:486–93.CrossRefPubMed
32.
Brown RH, Zhong L, Whitman AL, Lynch MG, Kilgo PD, Hovis KL. Reduced intraocular pressure after cataract surgery in patients with narrow angles and chronic angle-closure glaucoma. J Cataract Refract Surg. 2014;40:1610–4.CrossRefPubMed
33.
Shingleton BJ, Gamell LS, O’Donoghue MW, Baylus SL, King R. Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients. J Cataract Refract Surg. 1999;25:885–90.CrossRefPubMed
Metadata
Title
Comparison of the Ahmed glaucoma valve with the Baerveldt glaucoma implant: a meta-analysis
Authors
Yi-Wen Wang
Ping-Bao Wang
Chao Zeng
Xiao-Bo Xia
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2015
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-015-0115-y

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