Surgical Outcomes of Baerveldt Glaucoma Implant Versus Ahmed Glaucoma Valve in Neovascular Glaucoma: A Retrospective Multicenter Study.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2025-02-17 DOI:10.1007/s12325-025-03128-4

Kentaro Iwasaki, Sachi Kojima, Ryotaro Wajima, Akira Matsuda, Koki Yoshida, Aika Tsutsui, Michihiro Kono, Miho Nozaki, Koji Namiguchi, Keisuke Nitta, Yusaku Miura, Toshihiro Inoue, Tomomi Higashide, Kyoko Ishida, Masaki Tanito, Masaru Inatani

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Abstract

Introduction: This multicenter retrospective study compared the surgical outcomes of Baerveldt glaucoma implant (BGI) surgery with those of Ahmed glaucoma valve (AGV) surgery in patients with neovascular glaucoma (NVG).

Methods: The study included patients with NVG aged ≥ 20 years who had undergone BGI (223 eyes) or AGV (146 eyes) surgery between April 1, 2012 and December 31, 2021 across 10 clinical centers in Japan. Surgical success or failure was the primary outcome measure of this study. We defined surgical failure as a reduction of < 20% in the pre-operative intraocular pressure (IOP) or criterion A (IOP > 21 mmHg), criterion B (IOP > 17 mmHg), or criterion C (IOP > 14 mmHg). In addition, we considered a requirement for re-operation, loss of light perception, and hypotony as surgical failure.

Results: The surgical success rate of the BGI surgery group was significantly higher than that of the AGV group for criteria A (P = 0.01) and B (P = 0.01). Multivariate analysis revealed that AGV surgery showed significant associations with surgical failure for criteria A (hazard ratio, 1.74), B (hazard ratio, 1.72), and C (hazard ratio, 1.34). The overall incidence of postoperative complications was comparable between the two groups. The requirement for re-operation in the AGV surgery group was significantly higher than that in the BGI surgery group (12.3% vs. 5.8%, P = 0.03).

Conclusions: BGI surgery yielded a higher success rate than AGV surgery in patients with NVG for a target IOP of < 21 or < 17 mmHg. No significant differences were observed between the two procedures in terms of the incidence of postoperative complications. Additional glaucoma surgery was required more frequently following AGV surgery. Therefore, BGI surgery may be a more suitable and efficacious option for the management of IOP in patients with neovascular glaucoma compared with AGV surgery.

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.