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Arch Ophthalmol. 2004;122:104-105.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Glaucoma drainage implant surgery (GDIS) has substantially improved the treatment of patients with poor prognosis for standard filtering procedures, such as trabeculectomy. Early reports^1-4 described the beneficial treatment of refractory or recalcitrant glaucoma with GDIS; neovascular glaucoma⁵ and juvenile glaucoma^6-9; and glaucoma associated with uveitis,^10-11 penetrating keratoplasty,¹² epithelial ingrowth,¹³ aphakia or pseudophakia,^14-15 and failed filtering surgery.¹⁵ Recently, Wilson et al¹⁶ published the results of a clinical trial that demonstrated the safety and efficacy of surgery using the Ahmed implant compared with trabeculectomy for the initial surgical management of primary open-angle glaucoma.

THE ARGUMENTS

Two findings convincingly argue for the selection of GDIS over trabeculectomy in eyes with poor surgical prognoses: (1) the lower incidence of late-onset, bleb-related complications such as bleb leaks, blebitis, and endophthalmitis, and (2) the comparability of successful intraocular pressure lowering. The lower risk of late-onset complications after GDIS is explained by the nature and location of the . . . [Full Text of this Article]

EVIDENCE-BASED DECISION MAKING
Richard K. Parrish II, MD
From the Department of Ophthalmology, University of Miami School of Medicine, Miami, Fla.