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Comparison of surgical outcomes of ExPRESS shunt and Ahmed valve in neovascular glaucoma

Poster Details

First Author: I.Elhawary SAUDI ARABIA

Co Author(s):    A. Ahmed                    

Abstract Details


Neovascular glaucoma is a potentially devastating form of secondary glaucoma, which have a guarded visual prognosis. In the advanced stages of neovascular glaucoma, surgical management is often required to manage elevated intraocular pressure.The use of Ex-Press shunt and glaucoma drainage implant are two procedures often considered in managing patients who are refractory to medical therapy. Post operative intraocular pressure outcomes , decrease in need for glaucoma drops and surgical complications with either procedure were studied.


Magrabi Eye Hospital, Jeddah, Saudi Arabia


A retrospective comparative case series of Ahmed Valve and Ex-Press Shunt performed by the same surgeon. Patients with less than 3 post operative visits or more than one glaucoma surgery have been excluded. Pre-operative visual acuity (VA), intra- and post-operative complications, pre and post surgical IOP and glacuoma medications have been recorded.


21 Neovascular glaucoma patients with Ahmed Valve vs. 6 Ex-Press shunt were included in the study.Mean patient age was 70 years. Mean F/U time was 14 months for Ahmed Valve and 9.4 months for Ex-Press Shunt. 2 out of 23 Ahmed Valve patients required repeat excisional surgery but no Ex-Press Shunt required repeat surgery. These patients have been excluded from study. 2 out of 21 Ahmed Valve patients had hyphema, 1 Ahmed Valve patient had choroidal effusion.Ex-Press shunt patients required less glaucoma drops than Ahmed Valve patients. Mean IOP decrease in Ahmed Valve vs. Express Shunt was statistically not different.


Data suggests that Ex-Press shunt might be as or even more efficous in the treatment of neovascular glaucoma. Ex-Press shunt and Ahmed Valve lowered the IOP similarly. In addition, Ex-Press shunt patients required less glaucoma medications overall. Further research including recruitment of more patients and data points is required to confirm the role of express shunt in neovascular glaucoma.

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