Adjunctive Mitomycin C or amniotic membrane transplantation for Ahmed glaucoma valve implantation: A randomized clinical trial

Shahin Yazdani, Hassan Mahboobipour, Mohammad Pakravan, Azadeh Doozandeh, Elham Ghahari

Research output: Contribution to journalArticlepeer-review


Purpose: To determine whether adjunctive mitomycin C (MMC) or amniotic membrane transplantation (AMT) improve the outcomes of Ahmed glaucoma valve (AGV) implantation. Methods: This double-blind, stratified, 3-armed randomized clinical trial includes 75 eyes of 75 patients aged 7 to 75 years with refractory glaucoma. Eligible subjects underwent stratified block randomization; eyes were first stratified to surgery in the superior or inferior quadrants based on feasibility; in each subgroup, eyes were randomly assigned to the study arms using random blocks: conventional AGV implantation (group A, 25 eyes), AGV with MMC (group B, 25 eyes), and AGV with AMT (group C, 25 eyes). Results: The 3 study groups were comparable regarding baseline characteristics and mean follow-up (P=0.288). A total of 68 patients including 23 eyes in group A, 25 eyes in group B, and 20 eyes group C completed the follow-up period and were analyzed. Intraocular pressure was lower in the MMC group only 3 weeks postoperatively (P=0.04) but comparable at other time intervals. Overall success rate was comparable in the 3 groups at 12 months (P=0.217). The number of eyes requiring medications (P=0.30), time to initiation of medications (P=0.13), and number of medications (P=0.22) were comparable. Hypertensive phase was slightly but insignificantly more common with standard surgery (82%) as compared with MMC-augmented (60%) and AMT-augmented (70%) procedures (P=0.23). Complications were comparable over 1 year (P=0.28). Conclusions: Although adjunctive MMC and AMT were safe during AGV implantation, they did not influence success rates or intraocular pressure outcomes. Complications, including hypertensive phase, were also comparable.

Original languageEnglish (US)
Pages (from-to)415-421
Number of pages7
JournalJournal of Glaucoma
Issue number5
StatePublished - 2016
Externally publishedYes


  • Ahmed glaucoma valve
  • amniotic membrane
  • mitomycin C
  • success rate

ASJC Scopus subject areas

  • Ophthalmology


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