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Purpose : to compare the efficacy and safety of Ahmed and Molteno-3 drainage devices implantation in the surgical treatment of refractory glaucoma.  Patients and methods . Two groups of refractory glaucoma patients underwent surgery. In the first group (48 patients, 48 eyes) drainage device Molteno-3 with a site size of 175 mm2 was implanted. The average IOP in the group before surgery was 31.9 ± 7.7 mm Hg. The average number of glaucoma medications was 3.3 ± 0,44. In the second group (51 patients, 51 eyes) implantation of Ahmed Valve FP7 model was performed. The average level of IOP in the group before surgery was 34.7 ± 8.07 mm Hg. The average number of glaucoma medications was 3.08 ± 0.4.  Results . In the first group the average intraocular pressure level 1 month post-op was 14.6 ± 6.1 mm Hg, 3 months post-op 18.8 ± 5.2 mm Hg, 6 months post-op 16.5 ± 4.7 mm Hg. IOP сompensation (≤ 21 mm Hg) in 6 months was achieved in 91.6 % of cases and in 1 year in 100 % of cases. The total success was achieved only in 8.3 % of patients. However, the number of glaucoma medications was reduced to 1.6 ± 0.8. In the second group the average IOP level 1 month post-op was 21.25 ± 7.3 mm Hg, 3 months post-op 17.9 ± 5.3 mm Hg, 6 months post-op 15.7 ± 4.1 mm Hg. IOP сompensation in 6 months was achieved in 82.4 % of cases and in 1 year in 86.3 %. In the second group complete success was achieved in 19.6 % of patients. The number of glaucoma medications was 1.4 ± 1.1. In the first group complications were revealed in 22.9 % of cases (11 patients). Ciliochoroid detachment was revealed in 9 patients (18,8 %) and hyphema in 2 patients (4,2 %). In the second group complications were revealed in 19.6 % of cases (10 patients). Сiliochoroid detachment was revealed in 4 patients (7.8 %), diplopia in 5 patients (9.8 %), hyphema was detected in one case (1.9 %). In the first group IOP compensation (≤21 mm Hg) was achieved after 6 months in 91.6 % of cases and after 1 year in 100 % of cases. The complete success was achieved in only 8.3 %. In the second group, IOP compensation in 6 months was achieved in 82.4 % of cases and 86.3 % — in 1 year. In the second group, complete success was achieved in 19.6 % patients. There was no significant difference in complications between two groups.  Conclusion . High level of safety and effectiveness of refractory glaucoma surgical treatment with implantation of Molteno-3 and Ahmed drains was confirmed.

Valved and Non-Valved Drainage Systems in the Surgical Treatment of Refractory Glaucoma