Novel technique for fixating the plate of the Ahmed valve to the sclera using a single-flanged prolene suture

Abstract: PURPOSE: The purpose of this study was to evaluate a novel technique for fixating the plate of the Ahmed glaucoma valve (AGV) to the sclera using a single-flanged prolene suture. METHODS: This study involved 40 eyes of 40 patients diagnosed with different types of primary and secondary open-angle glaucoma who had undergone AGV implantation with plate fixation using a single-flanged prolene suture technique. The clinical data regarding the duration of surgery, intra- and postoperative complications, best-corrected visual acuity, intraocular pressure (IOP), and the number of IOP-lowering drugs were retrieved. RESULTS: The mean age of patients was 50.3 ± 11.8 years. The average follow-up period was 5.3 ± 1.7 months. The mean duration of surgery was 25.3 ± 6.7 min. Preoperatively, all patients were on full antiglaucoma medication with a mean IOP of 32.4 ± 6.3 mmHg. Significantly lower postoperative IOP than at baseline at all visits ( P < 0.05) was found. Postoperative IOP at 1 week, 1 month, and 3 months were 11.8 ± 3.6, 14.2 ± 4.2, and 15.3 ± 2.6 mmHg, respectively ( P = 0.002). In this study, complete success occurred in 30 (75%) cases, while qualified success was encountered in the remaining 10 (25%) cases with stable IOP 6-21 mmHg on a fixed dorzolamide–timolol glaucoma combination. The number of IOP-lowering medications was 1.8 ± 0.3 postoperative compared to 3.8 ± 0.4 preoperative. No cases of exposed or migrated tubes or plates were reported in this study. No major post operative complications in the form of tube touch to the iris, tube occlusion, shallow anterior chamber, hypotony, or choroid effusion occurred in this study. CONCLUSION: This novel technique of fixating the plate of AGV to the sclera using a single-flanged prolene suture is an efficient, safe, and reproducible technique that provides excellent stability without complications of free plate techniques and at the same time minimizes risks of conventional old valve plate fixation techniques.