Pretreatment with frequent topical betamethasone in Ahmed glaucoma valve implantation.

Objective: To evaluate the efficacy of pretreatment with topical betamethasone in Ahmed glaucoma valve (AGV) implantation.
Design: Randomized clinical trial.
Participants: Sixty-two eyes from 62 patients undergoing AGV.
Methods: We randomly assigned patients undergoing AGV to 2 arms of the study. The case group received AGV implantation with preoperative betamethasone eye drops, and the control group did not receive preoperative betamethasone. Follow-up examinations were performed on postoperative day 1, at least weekly for 4 weeks, and then every 1 to 3 months. Our main outcome measure was the rate of success, defined as intraocular pressure (IOP) <15 mm Hg and IOP ≤18 mm Hg.
Results: We analyzed 62 eyes divided to case (n = 33) and control (n = 29) groups. The success rate was significantly higher in the intervention group than in the control group at 12 months postoperatively when considering either IOP < 15 or IOP < 18 mm Hg as success (p < 0.001) and also at 6 months when considering IOP < 18 mm Hg as success (p < 0.041). The reduction in the number of antiglaucoma medications used postoperatively was significantly higher in the betamethasone group at follow-up at 1 and 3 months and 1 year.
Conclusion: Pretreatment with topical betamethasone in AGV implantations increases the success rate and reduces the need for medications.
(Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)