1Dr Muhammad Umair, 2Dr Muhammad Tariq Bangash, 3Dr Jameel Khan, 4Dr Syeddah
Hoor, Dr Allah Rakha

Clinical Outcomes Following Ahmed Glaucoma Valve
Implantation in Refractory Glaucoma

Abstract:

Refractory glaucoma represents a challenging form of glaucoma in which
intraocular pressure remains inadequately controlled despite appropriate medical therapy, laser
treatment, or conventional filtration surgery. Ahmed Glaucoma Valve implantation provides an
alternative pathway for aqueous humor drainage and is commonly considered when conventional
approaches are unsuccessful or carry a high risk of failure.This study evaluated the clinical
outcomes, intraocular pressure control, medication requirements, visual outcomes, surgical
success, and postoperative complications following Ahmed Glaucoma Valve implantation in
patients with refractory glaucoma.A clinical outcome framework was used to assess patients
undergoing Ahmed Glaucoma Valve implantation for refractory glaucoma. Relevant outcomes
included intraocular pressure, requirement for antiglaucoma medications, visual acuity, surgical
success, need for additional glaucoma surgery, and postoperative complications. Findings were
interpreted in relation to published long-term clinical evidence.Total 80 eyes were included. The
mean IOP fell from 31.8 ± 7.4 mmHg pre-operatively to 16.1 ± 4.5 mmHg at 12 months (49.4%
reduction; p<0.001). The mean number of antiglaucoma drugs was reduced from 3.4 ± 0.9 to 1.2
± 1.0 (p < 0.001). At 12 months surgical success was achieved in 66 (82.5%) eyes and surgical
failure in 14 (17.5%) eyes. The mean BCVA improved from 0.92 ± 0.61 to 0.78 ± 0.58 logMAR
GlobalHealth & Medicine. 2026; 8(3):408-418. Original Article
DOI:10.35772/ghm.2026.01075
(p=0.001). Postoperative problems occurred in 25 (31.3%) eyes. The most common
complications were hyphema (10.0%) and hypotony (7.5%). Previous glaucoma surgery was
substantially related with surgical failure (24.5% versus 6.5%, p=0.04).Clinical outcome
assessment was performed in 80 eyes of patients with refractory glaucoma who underwent
Ahmed Glaucoma Valve implantation. During follow-up, intraocular pressure (preoperative and
postoperative), antiglaucoma drug demand, visual acuity, surgical success, requirement of
subsequent glaucoma surgery and postoperative complications were assessed. Surgical success
was defined as clinically satisfactory IOP control, significant pressure reduction, no problems
endangering vision, and no additional glaucoma surgery. Data were analysed using descriptive
statistics, paired comparisons of preoperative and postoperative measures and categorical tests of
association with p<0.05 being statistically significant.

Key words
Ahmed Glaucoma Valve; refractory glaucoma; glaucoma drainage device; intraocular pressure;
glaucoma surgery; surgical outcomes; postoperative complications

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