Christmas Card quotThe Christmas Blessingquot

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The Ahmed versus Baerveldt (AVB) study is a randomized control trial of 238 patients with high-risk glaucoma refractory to medical therapy who underwent tube shunt implantation, either Ahmed or Baerveldt. Investigators found that Baerveldt was able to reduce both IOP and drop burden better than Ahmed in the long term. • IOP reduction (Ahmed vs Baerveldt) • at 5 years: 47% vs 57%, p=0.001 • Medication reduction (A v B): • at 3 years: 42% vs 65%, p=0.002 • at 5 years: 44% vs 61%, p=0.03 • This may be because the Baerveldt has a larger end plate, which could be the main contributor to the lower pressure. • The Baerveldt shunt is a non-valved device where a stent is placed and removed a few weeks later; at this point when scar tissue has formed around the end plate, therapeutic pressure reduction can occur. On the other hand, Ahmed is a valved device and was shown to immediately reduce pressure in the short term more effectively. • Ahmed valves were more likely to fail (A v B): • at 3 years: 51% vs 34%, p=0.03 • at 5 years: 53% vs 40%, p=0.04 • Baerveldt were more likely to have hypotony-related vision-threatening complications (A v B): • postoperatively: 0% vs 4%, p=0.02 • Because of the differences in these devices, figuring out which one is best for each individual is essential. • AVB 3-year Outcomes: https://pubmed.ncbi.nlm.nih.gov/23796... • AVB 5-year Outcomes: https://pubmed.ncbi.nlm.nih.gov/27544... • For this video, the Ophthalminute Team would like to give a special thanks to Amin Karadaghy (PGY-1 at the University of Kansas) for giving suggestions which made this video better.

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