Refractory Primary Open Angle Glaucoma Clinical Trial
Official title:
Re-Trabeculectomy Versus Ahmed Glaucoma Valve Implantation in Secondary Surgical Management of Patients With Refractory Primary Open Angle Glaucoma: a Three-year Comparative Study
The purpose of this study is to compare three-year outcomes of re-trabeculectomy with those of Ahmed glaucoma valve implantation in secondary surgical management of patients with primary open angle glaucoma (POAG) and a history of previous failed trabeculectomy.
Currently, lowering intraocular pressure (IOP) is the only treatment modality to prevent or
slow progression of glaucomatous optic nerve damage. Incisional procedures are indicated
when medical therapy and/or laser procedures cannot adequately reduce IOP. Trabeculectomy is
the most common glaucoma incisional procedure globally. On the other hand, glaucoma drainage
devices that have been historically reserved for cases of glaucoma deemed at high risk of
failure have increasingly gained popularity particularly in eyes with previous history of
glaucoma surgery.
There is still no agreement on the appropriate surgical procedure in those with prior
glaucoma surgery. The five-year tube versus trabeculectomy (TVT) study, which evaluated the
efficacy and safety of Baerveldt glaucoma implant versus trabeculectomy, showed that both
surgical procedures had similar IOP reduction and use of anti-glaucoma medication; tube
shunt surgery had a higher success rate than trabeculectomy with mitomycin C (MMC); the
trabeculectomy/MMC had higher incidence of early postoperative complications compared to
tube shunt surgery; and rates of late postoperative complications, reoperation for
complications, and cataract extraction were comparable in both treatment groups.
In this study, the investigators compared three-year outcomes of re-trabeculectomy with
those of Ahmed glaucoma valve implantation in secondary surgical management of patients with
primary open angle glaucoma and a previous history of failed trabeculectomy.
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Observational Model: Cohort, Time Perspective: Prospective