Abstract
BACKGROUND: To evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation in treating refractory glaucoma and analyze the factors influencing the surgical success rate. METHODS: A 3-year retrospective analysis was conducted on 199 patients with refractory glaucoma treated with AGV, model FP7.Preoperative and postoperative data, including intraocular pressure (IOP), visual acuity, number of glaucoma medications, and surgical outcomes, were analyzed. Complete success was defined as an IOP ≤ 21 mmHg without the use of glaucoma medications or additional filtration surgery, and a reduction in IOP of ≥ 15% from baseline. The qualified success was defined as: IOP ≤ 21 mmHg with adjunctive medications or the reduction of IOP < 15% from baseline. The overall success encompassed both complete success and qualified success. RESULTS: Complete Success rates were 60.5% and 56% at years 1 and 3, respectively. Overall success rates were 83% and 74.7% at the same intervals. Visual acuity (VA) showed statistically significant improvement at year 1 (P < 0.05), but changes at year 3 were not significant (P > 0.05). Low preoperative IOP and a history of pan-retinal photocoagulation (PRP) were identified as protective factors contributing to the success of surgical outcomes at year 1. CONCLUSION: AGV implantation is a safe and effective treatment for neovascular glaucoma. Preoperative IOP and a history of PRP significantly influence surgical success at one year, with success rates declining over 3 years. Careful surgical execution is crucial for achieving optimal outcomes. TRIAL REGISTRATION: This retrospective study was registered in Chinese Clinical Trial Register (ChiCTR2400089879).