Comparison of Aurolab Aqueous Drainage Implant with Ahmed Glaucoma Valve for refractory glaucoma: a meta-analysis

Background: The purpose of this study was to compare the efficacy and safety of the Aurolab aqueous drainage implant（AADI）and the Ahmed glaucoma valve(AGV) for the treatment of refractory glaucoma. Methods: We comprehensively searched four databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library databases, selecting the relevant studies. The continuous variables, namely, intraocular pressure reduction (IOPR) and a reduction in antiglaucoma medication (AGMR), were pooled by the weighted mean differences (WMDs), and the dichotomous outcomes, including success rates and complications were pooled by the odds ratio (ORs). Results: A total of 825 eyes from 820 patients from six studies were included. The WMDs of the IOPR between the AADI and the AGV implant were 0.58 (95 % CI:0.07 to 1.09) at 3 months, 0.44 (95 % CI: 0.11 to 0.77) at 6 months, 2.20 (95 % CI: 0.63 to 3.77) at 12 months, and 3.24 (95 % CI: 1.73 to 4.75) at follow-up endpoint. Significant difference was detected between the two groups at any point in time. The WMDs of the AGMR between the AADI and the AGV implant were 0.87(95 % CI: 0.61 to 1.13) at 6 months, 1.04(95 % CI: 0.66 to 1.42) at 12 months, and 0.93 (95 % CI: 0.52 to 1.34) at the follow-up endpoint , the differences reached statistical significance at any point in time. The pooled ORs comparing the AADI with the AGV were 3.68(95 % CI: 2.58 to 5.25) for the complete success rate and 1.72(95 % CI: 1.24 to 2.39) for qualified success rate, significant difference was detected between the two groups. There were no significant differences between the AADI the AGV implant on the rates of adverse events. Conclusions: The AADI is more effective in both its surgical success rate and reducing IOP and AGM. And the two implants may have comparable incidences of adverse events.