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Abstract #119304 Published in IGR 25-1
Modified ex-PRESS technique versus Ahmed glaucoma valve as primary glaucoma surgery for hereditary transthyretin amyloidosis glaucoma
Barbosa Ribeiro B; Vieira R; Vieira R; Ferreira A; Marta A; Figueiredo A; Reis R; Sampaio I; Sampaio I; Melo Beirão J; Melo Beirão J; Menéres MJAmyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis 2024; 31: 302-308
BACKGROUND: To compare the efficacy of modified Ex-PRESS technique (ExP) versus Ahmed Glaucoma Valve (AGV) as primary surgery in hereditary transthyretin amyloidosis (ATTRv) secondary glaucoma. METHODS: Retrospective study at the national amyloidosis centre. Success was defined as an IOP ≥ 6 mmHg and ≤ 21 mmHg with no need for further glaucoma surgery or laser trabeculoplasty and without loss of light perception at the time of the last follow-up. Secondary outcomes included surgical complications, need for hypotensive drugs, and endothelial cell loss. Patients submitted to previous glaucoma surgery were excluded. RESULTS: We included 180 eyes of 150 patients, 121 in AGV and 59 in ExP group. No significant baseline differences were found between groups. At the time of last follow-up, both groups exhibited significant intraocular pressure (IOP) reduction ( < .001) and number of glaucoma medications ( < .001). Kaplan-Meyer analysis showed higher cumulative probability of success for AGV group (80.1% vs. 41.1%, < .001) and higher mean time to failure (54.5 vs. 36.9 months, respectively, < 0.001) at 60 months follow-up. AGV showed lower hazard (HR 0.21, 95% CI [0.111-0.407], < .001) for failure. CONCLUSION: AGV and ExP are safe and effective techniques in the treatment of ATTRv secondary glaucoma. However, AGV's efficacy seems to be more durable.
Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
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