Experience with the use of Baerveldt and Ahmed glaucoma drainage implants in an Asian population

Purpose: To evaluate the efficacy and safety of Baerveldt and Ahmed glaucoma drainage implants in Asian patients with refractory glaucoma. Design: Retrospective nonrandomized study. Participants: Forty-one patients. Methods: The authors reviewed the insertion of 18 Ahmed glaucoma valved (AGV-S2) implants and 24 350 mm 2 Baerveldt glaucoma implants performed by a single surgeon at the Department of Ophthalmology, National University Hospital, Singapore, from January 1, 2000, to December 31, 2000. A total of 42 glaucoma drainage implants was inserted into the eyes of 41 patients. All patients had at least 6 months of follow-up. Main Outcome Measures: Intraocular pressure (IOP), visual acuity, and complications. Results: Both drainage implants achieved remarkable reductions in IOP; from pretreatment IOP of 40.1+/-13.8 mmHg and 43.7+/-9.3 mmHg to postoperative IOP of 17.4+/-6.2 and 14.9+/-5.5 mmHg in the Baerveldt and Ahmed groups, respectively. A decrease in IOP of 56.6% and 65.9% had been achieved. Success rates were 20 (83.3%) for Baerveldt and 12 (66.7%) for Ahmed implants, whereas qualified success occurred in 1 (4.2%) Baerveldt and 3 (16.7%) Ahmed implants. Conversely, failure to control IOP occurred in 3 (12.5%) Baerveldt implants and 3 (16.7%) Ahmed implants. More than 80% of the patients had maintained or improved visual function, whereas only 4 (16.0%) of the patients with Baerveldt implants and 2 (16.7%) patients with Ahmed implants had loss of more than 1 Snellen line. Conclusions: Both Baerveldt and Ahmed glaucoma drainage implants performed well in terms of IOP control, preservation of visual function, and having low complication rates. (C) 2004 by the American Academy of Ophthalmology.