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Tina M Roa,1 Peter A Netland,1 Vital P Costa,2 Steven R Sarkisian Jr,3 Lama A Al-Aswad,4 Marlene R Moster,5 Iqbal IK Ahmed6 1Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA; 2Department of Ophthalmology, University of Campinas, Campinas, Brazil; 3Oklahoma Eye Surgeons, PLLC, Oklahoma City, OK 73112, USA; 4Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY 10017, USA; 5Glaucoma Service, Wills Eye Hospital, Philadelphia, PA 19107, USA; 6Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, CanadaCorrespondence: Peter A NetlandUniversity of Virginia School of Medicine, PO Box 800715, Charlottesville, VA 22908, USATel +1 434 982-1086Email pan9c@virginia.eduPurpose: Our aim was to evaluate and compare the clinical outcomes after implantation of the silicone-plate (model FP7) and porous polyethylene-plate (model M4) Ahmed Glaucoma Valves.Patients and Methods: This was a prospective, multicenter, comparative series. A total of 52 eyes (52 patients) were treated with either the silicone or porous plate Ahmed Glaucoma Valve implant. Hypertensive phase was defined as intraocular pressure > 21 mmHg during the first 3 months postoperatively. Success was defined as 5 mmHg ≤intraocular pressure ≤ 21 mmHg (with or without additional glaucoma medications), without loss of light perception and without additional glaucoma procedures. Patients were monitored for 1 year after surgery.Results: The pre-operative intraocular pressure was 29.9 ± 6.6 mmHg and 33.8 ± 10.5 in the silicone-plate and porous-plate groups, respectively (P = 0.118). At 12 months after surgery, the mean intraocular pressure was 13.6 ± 4.7 mmHg in the silicone-plate group and 17.9 ± 10.9 mmHg in the porous-plate group (P = 0.141). The mean number of glaucoma medications at 12 months was 1.64 ± 1.40 mmHg and 1.89 ± 1.54 mmHg in the silicone- and porous-plate groups, respectively (P = 0.605). Hypertensive phase was not significantly different in the two groups (50.0% of the silicone-plate and 57.7% of the porous-plate groups, P = 0.578). At 12 months after surgery, the percent success for the silicone-plate and porous-plate groups was 88.5% and 53.8%, respectively (P = 0.005). Complications were similar in the two groups.Conclusion: The porous-plate Ahmed Glaucoma Valve showed similar average intraocular pressure reduction compared with the silicone-plate model. At 12 months after surgery, there was a significantly lower success rate in the porous-plate compared with the silicone-plate group.Keywords: Ahmed Glaucoma Valve, model FP7, model M4, glaucoma drainage implant, porous polyethylene, Medpor

Feyzahan Ekici, Marlene R Moster, Victor Cvintal, Wanda D Hu, Michael Waisbourd Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA Purpose: To investigate the clinical outcomes of tube shunt coverage using sterile gamma-irradiated cornea allograft.Patients and methods: The Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the medical records of 165 patients who underwent glaucoma tube shunt procedures using sterile gamma-irradiated cornea allograft (VisionGraft) between December 2012 and November 2013. Demographic characteristics, type of tube shunt, and position were noted. Complications were recorded at 1 day; 1 week; 1, 3, 6, and 12 months; and on the final postoperative visit.Results: One hundred and sixty-nine eyes of 165 patients were included. The mean follow-up time was 4.8±3.5 (ranging from 1 to 16) months. There was no evidence of immunological reaction, infection, or exposure in 166 eyes (98.2%). Three eyes (1.8%) experienced graft or tube exposure within the first 3 postoperative months. Two of the cases had underlying diseases: bullous pemphigoid and chronic allergic conjunctivitis.Conclusion: Coverage of tube shunts using gamma-irradiated cornea allograft had a low exposure rate and was well tolerated. The graft can be stored long term at room temperature and has an excellent postoperative cosmetic appearance.Keywords: aqueous shunts, gamma-irradiated cornea allograft, glaucoma drainage device, tube shunt surgery