This triple-blind, stratified, randomized clinical trial includes 100 eyes of 100 patients
aged 18 to 85 years with refractory glaucoma. Eligible subjects undergo stratified block
randomization; eyes are first stratified to one of four subgroups: group 1:patients with
previous failed trabeculectomy, group 2: uveitic glaucoma, group 3: neovascular glaucoma and
group 4: other indications like aphakic glaucoma or glaucoma associated with vitreoretinal
procedures.
In each subgroup, eyes are randomly assigned to the study arms using random blocks:
conventional Ahmed Glaucoma Valve (AGV) implantation (group A, 50 eyes), Ahmed Glaucoma Valve
(AGV) with intraoperative periplate triamcinolone injection (group B, 50 eyes).
Patients will be followed for one year. They will undergo full ophthalmology examination at
first day, first week, month 1, 3, 6, 9 and 12 after the surgery.
The primary outcome measure is cumulative probability of success, defined as intraocular
pressure (IOP) of 6-21 mm Hg, with or without medication, and no serious complications,
additional glaucoma surgery, or loss of light perception.
The outcomes will be compared between two arms in each subgroup.
The number of eyes requiring medications, time to initiation of medications, and number of
medications will be compared.