Surgical outcomes of Ahmed Glaucoma Valve Implantation surgery: With mitomycin C and without mitomycin C

Abstract

Background: The Ahmed Glaucoma Valve (AGV) is a commonly used glaucoma drainage device (GDD) in the surgical management of glaucoma patients. Adjunctive mitomycin C (MMC) has demonstrated clear benefits in improving the surgical outcomes of trabeculectomy surgery. The effectiveness of MMC in improving the surgical outcomes of GDDs remains uncertain. This study seeks to compare the surgical outcomes of AGV implantation with and without the use of intraoperative MMC in an African cohort.
Methods: This retrospective case series analysed 98 eyes in 95 patients who underwent AGV implantation from 01 January 2016 to 31 December 2021 at two units located in Cape Town, South Africa. The postoperative data collected included intraocular pressure (IOP), medication use, and complications.
Results: The eyes were categorised into the MMC use (n = 46) or non-MMC use (n = 52) group. In most eyes within the MMC use group (78.3%, n = 36), a concentration of 0.2 mg/mL was used. The mean preoperative IOP in the MMC group and the non-MMC group was 38 and 33, respectively (p = 0.12). At 1 year, the mean IOP in the MMC use group (n = 31) was 18 mmHg and 16 mmHg in the non-MMC group (n = 36) (p = 0.84). The frequency of complications and the hypertensive phase were comparable in the two groups.
Conclusion: This study found no difference between the two groups in terms of IOP control, postoperative medication use, and complications. This may be attributed to the low concentration of MMC used in our cohort.
Contribution: This study provides insights into the role of MMC use in AGV implantation.