Cyclophotocoagulation Versus Ahmed Glaucoma Implant In Neovascular Glaucoma With Poor Vision At Presentation

To evaluate the outcomes of surgical intervention in eyes with neovascular glaucoma (NVG) and poor vision, comparing the
Ahmed glaucoma implant with cyclophotocoagulation (CPC).

Double-armed cohort retrospective study

This study is a double-armed cohort retrospective review of medical records of patients with NVG who had
a visual acuity of 20/200 or less and underwent one of the two procedures as a primary intervention: Ahmed glaucoma valve (AGV) or
cyclophotocoagulation (CPC). The study was conducted at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, from
January 2014 to June 2019, with a total study period of 1 year. The main outcome measures included the surgical success rate, changes
in intraocular pressure (IOP), the number of antiglaucoma medications, corrected distance visual acuity, and the reoperation rate for
glaucoma.

The preoperative IOP was 40.4 ± 10.6 mmHg (Median 40) in the CPC group and 39.4 ± 10.2 mmHg (Median 40) in the
AGV group (P = 0.6). At 1 year, the IOP ranged from 12.5 to 28 mmHg (Median 18) in the CPC group and 14 to 21.5 mmHg (Median
17) in the AGV group (P = 0.016). Survival analysis showed a 51% success rate in the CPC group and an 89% success rate at 1 year in
the AGV group (p>0.0001).

CPC and AGV procedures yielded good outcomes with similar IOP levels 12 months after the surgery. However, AGV
demonstrated a higher overall success rate and a lower medication requirement than CPC.