A Novel Surgical Technique for Ahmed Glaucoma Valve Implantation Without Plate Sutures.

Precis: A modification to the surgical technique of Ahmed glaucoma valve (AGV) implantation without plate sutures or surgical glue products has a similar safety and efficacy profile than the standard procedure, in the short and mid-term follow-up. Purpose: The purpose of this study was to assess the safety and efficacy of a modified AGV implantation technique without plate sutures. Methods: A retrospective case-control study including patients seen in the Glaucoma service of an academic institution. Patients that underwent a modified AGV implantation without plate sutures were included as cases and patients that underwent standard AGV implantation, as controls. Success was defined as intraocular pressure (IOP) reduction >20%, IOP >5 and <21 without the need for additional surgical intervention, and maintenance of light perception. Results: A total of 170 eyes were included. Mean (range) follow-up was 11.2 +/- 7.39 (3 to 24) months. There was no statistically significant difference in visual acuity and IOP between the groups during the postoperative period. In a univariate analysis, there was a larger decrease in IOP for the no plate suture group at the 6 months (-15.6 +/- 11.6 vs. -11.5 +/- 10.5, P=0.04) and 1 year (-16.4 +/- 10.4 vs. -11.1 +/- 10.4, P=0.02) visits. There was also a larger decrease in number of medications in the no plate suture group in the 3 months (-1.65 +/- 1.5 vs. -1.13 +/- 1.22, P=0.02), 6 months (-1.55 +/- 1.44 vs. -0.98 +/- 1.3, P=0.01) and 1 year (-1.70 +/- 1.5 vs. -1.04 +/- 1.2, P=0.04) visits. However, those differences were not confirmed by a multivariable model after adjusting for glaucoma type and number of previous glaucoma surgeries. No differences in the trajectory of the survival curves were noted between groups (P=0.36). Conclusion: The comparison of short and mid-term outcomes of patients undergoing AGV implantation using both techniques showed similar outcomes and success rates.