![]() The Ahmed Baerveldt Comparison (ABC) study demonstrated that both types of tube shunts had similar surgical success at 5 years. ![]() There have been two multicenter, randomized, clinical trials examining the Ahmed (valved) device versus the Baerveldt (non-valved) shunt. Comparisons: Ahmed Device vs Baerveldt Shuntīecause the various tube shunts have different sizes, features, and surgical techniques associated with them, the decision of which tube shunt to have implanted depends on your particular situation and your surgeon’s preference. The risk of the eye pressure falling too low, while rare, is somewhat higher with these devices than with the Ahmed valve, but non-valved shunts sometimes work better for attaining a lower eye pressure. The tube opens when a special suture that the surgeon has used to tie off the tube dissolves over time, or another type of suture that the surgeon will remove approximately 4-6 weeks after surgery in the office. In this case, some scarring has to take place initially before the tube opens, otherwise the eye pressure will be too low. Sometimes the tube shunt is not attached to a valve (e.g., the Baerveldt or Molteno shunts). ![]() ![]() However, in many patients, supplemental glaucoma medications such as eye drops are still required after an Ahmed valve is implanted to keep eye pressure within a normal range. The valve function of a glaucoma drainage device limits the flow of eye fluid in one direction, which puts a theoretical limit to how low the eye pressure can drop. The Ahmed Glaucoma Valve is the most commonly used type of shunt. There are several types of tube shunts available and typically the tube shunt that is chosen is based on your specific situation and the surgeon’s preference. Tube Shunts and ValvesĪ “valve” is one type of tube shunt that could be implanted during your tube shunt surgery. The tube shunt is covered by Medicare and most insurance plans. Trabeculectomy Study stay tuned for results). To weigh these factors, there is currently an ongoing trial comparing tube shunt versus trabeculectomy in patients who have had no prior ocular surgery (PTVT Study: Primary Tube vs. Generally, trabeculectomy is thought to reduce the eye pressure to a greater degree than tube shunt surgery, but there are greater risks. In recent years, some surgeons are using tube shunts or glaucoma drainage devices as first-line surgery, and forgoing standard trabeculectomy as the first surgery. Those results showed that after five years, tube shunt surgery had a higher success rate compared to trabeculectomy, with similar reductions in eye pressure and the need for supplemental glaucoma medications. Tube shunts have also been successful in controlling eye pressure in other types of glaucoma, such as glaucoma associated with uveitis or inflammation, neovascular glaucoma (associated with diabetes or other vascular eye diseases), pediatric glaucoma, traumatic glaucoma, and others.Ī multicenter randomized clinical trial (the Tube Versus Trabeculectomy or TVT Study) was conducted in patients who had previous surgery, including, trabeculectomy and/or cataract surgery. Traditionally, tube shunts were used to control eye pressure in patients in whom traditional eye surgery to relieve fluid pressure ( trabeculectomy) had previously failed, or in patients who have had previous surgeries or trauma that caused substantial scarring of the conjunctiva. Who Is a Candidate for Glaucoma Tube Shunt Surgery? The Ahmed valve implant procedure is done as outpatient surgery. The fluid that collects is then absorbed by the eye’s own veins and transported out of the eye cavity. The tube portion enters the front of the eye, or anterior chamber, while the rest of the implant sits on the surface of the eyeball underneath the conjunctiva and is covered by the eyelid. The Ahmed shunt itself is shaped like a miniature computer mouse with a tube at the end of it. The entire implant is covered with the eye’s own external covering. The Ahmed Glaucoma Valve is a commonly used type of glaucoma drainage implant made of silicone or polypropylene, a material that won’t break down in the body. One type of incisional glaucoma surgery uses a tube shunt, which is a flexible glaucoma drainage device that is implanted in the eye to divert aqueous humor (the fluid inside the eye) from the inside of the eye to an external reservoir. However, if eye drops and other medications prove ineffective, or if the patient can’t tolerate side effects from medications, then the doctor may recommend surgery. Many people with glaucoma are able to successfully control their eye pressures-and prevent vision loss-for years and even decades through the use of prescribed medications. This article explores the risks, benefits, and potential complications of tube shunt surgery as a treatment for glaucoma.
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