Researchers at Aravind Eye Hospital in Madurai, India, recently conducted a study of 85 patients intended to assess the effectiveness of the nonvalved Aurolab aqueous drainage implant (AADI) in treating neovascular glaucoma (NVG). Overall IOP control with medication was achieved in 86% of the 85 NVG eyes treated with surgical insertion of the AADI, and IOP control without medication in 81% of eyes at 2-year follow-up, according to findings reported in The British Journal of Ophthalmology.

The cumulative probable failure rate — an IOP of greater than 21 mmHg, IOP reduced by less than 20% from baseline, IOP less than or equal to 5 mmHg on 2 consecutive visits, reoperation for glaucoma, a complication, or loss of light perception vision — was 34% at 2 years. This is reportedly comparable to or better than the rates described the Ahmed, Baerveldt, and Molteno glaucoma drainage implants. The AADI was shown to effectively control IOP in NVG patients and may function as a more cost-effective option in resource-limited areas, the authors wrote.

Among participants, the most common causes of NVG were proliferative diabetic retinopathy and central retinal vein occlusion. Mean IOP decreased from 36.8±12.5 mmHg at baseline to 15.8±7.5 mmHg at the 2-year follow-up (P<.001). The number of IOP-lowering medications required was reduced from 3.4±0.8 to 1.5±1.1 (P<.001).

The cumulative rate of failure increased from 3.1% at 1 year to 33.8% at 2 years, and multivariable analysis revealed a lower failure risk for eyes with open angles. The logarithm of minimum angle of resolution visual acuity went down from 0.98±0.7 to 1.8±1.0 at 2 years (P<.001). The researchers believe that early AADI implantation at the open-angle stage of NVG may yield better results.