Comparison of Aurolab Aqueous Drainage Implant with Ahmed Glaucoma Valve for Refractory Glaucoma: A Meta-Analysis

Abstract

Background: Ahmed glaucoma valve (AGV) is a common surgical method for the treatment of refractory glaucoma.Aurolab aqueous drainage implant (AADI) is a novel surgical method which has been applied in clinical practice in recent years. Objective: The purpose of this study was to compare the efficacy and safety of the AADI and the AGV for the treatment of refractory glaucoma. Methods: We comprehensively searched four databases, including PubMed, Embase, Web of Science, and the Cochrane Library databases, selecting the relevant studies. The continuous variables, namely, intraocular pressure reduction (IOPR) and a reduction in antiglaucoma medication (AGMR), were pooled by the weighted mean differences (WMDs), and the dichotomous outcomes, including success rates and complications, were pooled by the odds ratio (OR). Results: A total of 825 eyes from 820 patients from six studies were included. The WMDs of the IOPR between the AADI and the AGV implant were 0.58 (95% CI: 0.07–1.09) at 3 months, 0.44 (95% CI: 0.11–0.77) at 6 months, 2.20 (95% CI: 0.63–3.77) at 12 months, and 3.24 (95% CI: 1.73–4.75) at follow-up endpoint. Significant difference was detected between the two groups at any point in time. The WMDs of the AGMR between the AADI and the AGV implant were 0.87 (95% CI: 0.61–1.13) at 6 months, 1.04 (95% CI: 0.66–1.42) at 12 months, and 0.93 (95% CI: 0.52–1.34) at the follow-up endpoint; the differences reached statistical significance at any point in time. The pooled ORs comparing the AADI with the AGV were 3.64 (95% CI: 2.44–5.45) for the complete success rate and 1.72 (95% CI: 1.24–2.39) for qualified success rate; significant difference was detected between the two groups. There were no significant differences between the AADI and the AGV implant on the rates of adverse events. Conclusions: The AADI is more effective in both its surgical success rate and reducing IOP and AGM. And the two implants may have comparable incidences of adverse events.