Researchers led by Sapna Sinha, MD, of Wills Eye Hospital set out to compare the efficacy and safety of Ahmed (New World Medical) and Baerveldt (Johnson & Johnson) glaucoma drainage devices in uveitic glaucoma. The findings, reported in the Journal of Glaucoma, demonstrated the strengths and weaknesses of each device.

The retrospective study included patients who underwent Ahmed or Baerveldt glaucoma drainage device implantation with a minimum follow-up of 3 months. Success was defined as IOP ≥6 mmHg and ≤21 mmHg; a >20% reduction on 2 consecutive visits after the third month with (qualified success) or without (complete success) medications; and no further glaucoma surgery or loss of vision. IOP, number of medications, visual acuity, complications, and interventions were compared between groups.

In total, 137 eyes of 122 patients (67 Ahmed, 70 Baerveldt) were included. The preoperative IOP and number of medications in the Ahmed group (32.7±10.3 mmHg; 4.1±1.3) were similar to Baerveldt (32.1±10.2 mmHg; 4.3±1.3.). These numbers at the last follow-up were 18.1±9.8 mmHg (2.1±1) with Ahmed and 12.7±6.9 mmHg (1.3±1.3) with Baerveldt.

The Baerveldt had greater IOP reduction (60.3% vs 44.5%) and a better complete success rate (30% vs 9%) with a higher complication rate (51.4% vs 20.9%). The de novo glaucoma reoperation rate was 19% in the Ahmed group and 4% in the Baerveldt group. Hypotony resulted in failure in 7 eyes (10%) in the Baerveldt group and none in the Ahmed group. The higher complete success rate and significantly greater reductions in mean IOP and number of medications were observed in the Baerveldt group, but with a higher rate of complications, including hypotony.