To compare surgical outcomes in patients with glaucoma secondary to Fuchs Heterochromic Iridocyclitis (FHIC) who underwent trabeculectomy with mitomycin C (MMC) versus Ahmed glaucoma valve (AGV) implantation.

In this retrospective comparative case series, we reviewed 26 eyes of 26 glaucoma patients with FHIC had undergone AGV implantation (12) or trabeculectomy with MMC (14) that had at least one year of follow-up. Failure was defined as IOP > 21 mmHg, IOP reduction < 20 % of baseline or IOP < 5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, or loss of light-perception. Statistical methods consisted of t-test, Mann-Whitney, Chi-Square and Fisher exact test, paired t-test and Wilcoxon singed rank test.

The average follow-up was 34 months (range 16.3- 51.7) for trabeculectomy group and 33.4 months (range 14.8- 52) for the AGV group. Patients in both groups were comparable in their baseline characteristics including age, sex, number of glaucoma medications, phakic status and preoperative IOP. The mean (± SD) IOP at the time of presentation was 23.4(±3.3) and 24(±7.8) in trabeculectomy and AGV group respectively (P= 0.8) which significantly decreased to 18.7 (±2.9) and 18.1 (±4.2) in each group after surgery. There was no statistically significant difference between both groups in post-operative visual acuity and intraocular pressure. During follow-up period, Success was 41.7 % and 64.1 % in trabeculectomy and Ahmad glaucoma valve group, respectively (P= 0.43). Seven patients in trabeculectomy group underwent phacoemulsification afterward, which was significantly higher than AGV group (P= 0.009).

The success rate of trabeculectomy with MMC and AGV implantation were comparable in eyes with glaucoma secondary to FHIC, even though the rate of cataract surgery was higher after trabeculectom.