Valve and implant compared for refractory glaucoma

Patients with refractory glaucoma in whom a proprietary glaucoma implant (Baerveldt, Abbott Medical Optics) was placed needed significantly less adjunctive medication to experience success in treatment compared with those who received a proprietary glaucoma valve (Ahmed FP7, New World Medical). However, fewer of those in the latter group had serious postoperative complications, according to 3-year outcomes reported in a study published online by Ophthalmology.

The multicentre, randomized, controlled clinical trial included 133 participants in the implant group and 143 in the valve group. Participants were aged 18 to 85 years and had IOP ≥18 mmHg. They were randomly assigned to receive the implant or valve.

The main outcomes at 3 years as measured by researchers from the UK, the US and Brazil:

• IOP. The investigators found that IOP (mean ± standard deviation) was 14.3 ± 4.7 mmHg in the valve group and 13.1 ± 4.5 mmHg in the implant group.
• VA. The mean change in the logarithm of the minimum angle of resolution VA was similar in both treatment groups.
• Supplemental medical therapy. Participants were taking 2.0 ± 1.4 glaucoma medications in the valve group and 1.5 ± 1.4 in the implant group.
• Complications. Postoperative complications associated with reoperation or vision loss of >2 Snellen lines occurred in 24 patients in the valve group and 38 patients in the implant group.
• Failure (defined as IOP >21 mmHg or not reduced by 20% from baseline, IOP

For more information, you can access the abstract here.