Early and Late Complications of Ahmed Glaucoma Valve Implant in a Real-World Situation

Purpose:  To determine the early and late complications of Ahmed Glaucoma Valve (AGV) implant surgery. Study Design:  Interventional case series. Place and Duration of Study:  Ophthalmology department of MTI-Hayatabad Medical Complex Peshawar, from May 2018 to February 2023. Methods:  All the patients between May 2018 and February 2023 who underwent AGV implant were included in the study. Data included patient's age, gender, indications for surgery, type of AGV implant used, length of follow-up period, intraocular pressure (IOP), number of topical glaucoma medications used, early and late complications, and the final outcome. Continuous variables (duration of follow-up, best corrected visual acuity, IOP, and number of topical anti-glaucoma medications) were represented in means and standard deviations. Paired t-test was applied for comparison of means between baseline and last follow-up data. A p-value of < 0.05 was considered statistically significant. Results:  A total of 28 eyes were included. Mean age of the patients were 28.75 ± 20.5 years. Duration of follow-up was 213.96 ± 169.33 days. There were 53.85% females. Commonest indication was congenital glaucoma 7 (25%). Majority, (n = 18, 64.3%) of the eyes had previous cataract surgeries followed by glaucoma, 13 (46.4%). The commonest early post-operative complication was hyphema (25%) and commonest late complication was hypertensive episode 32.1%. Majority of the eyes 23 (82.1%) did not require any further intervention for these complications. Conclusion:  Majority of AGV complications are self-limiting, necessitating just conservative therapy. However, serious complications might happen that could lead to blindness, therefore the surgeons should have strategies for treating or preventing them.