Posters

An audit to review the use of Ahmed valves to lower intraocular pressure in patients with glaucoma in Singleton Hospital, Swansea

Poster Details

First Author: S.Nardeosingh UK

Co Author(s):    M. Austin                    

Abstract Details

Purpose:

To assess whether the current practice and results of Ahmed valve (AGV) operations in Singleton Hospital, Swansea are within accepted guidelines and standards.

Setting:

A retrospective study looking at all patients having aqueous shunt surgery in Singleton hospital, Swansea between 02/01/2012 - 31/12/17.

Methods:

Patients selected for aqueous shunt surgery were selected based on clinical judgment as per National Institute for Health and Care Excellence (NICE), American Academy of Ophthalmology (AAO), and European glaucoma society (EGS) guidelines. All patients included required a minimum of 2 years follow-up. 17 eyes from 14 patients were included in total, 9 female and 5 male. The age ranged from 24-88 and of the 14 patients, 13 were white British and 1 was Asian. The standard for this audit was the Five-year treatment outcomes in the Ahmed Baerveldt comparison (ABC) study by Budenz et al.

Results:

The average intra-ocular pressure (IOP) dropped to 12.75mmHg ± 3.97 (n=16) at year 1 and 11.60mmHg ± 2.97 (n=5) at year 2 following AGV Surgery from a baseline of 32.76mmHg ± 8.04 (n=17). The average number of medication required to control the IOP dropped to 1.44 ±1.31 (n=17) at year 1 and 1.20 ± 1.64 (n=5) at year 2 from a baseline of 3.47 ± 0.87 (n=17). Interestingly, the average visual acuity (VA) preoperatively of 0.675 ± 0.644 logMAR improved to 0.224 ± 0.331logMAR (p=0.0039) following AGV insertion.

Conclusions:

All patients were in keeping with the guidelines (NICE,AAO and EGS). The results of this audit are comparable with the ABC trial. Ahmed valve insertion lowered IOP and medication use from baseline. In this study there was a significant improvement in VA following AGV insertion too. AGV surgery should be considered for those with refractory raised IOP.

Financial Disclosure:

None