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Atenção Primária à Saúde

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¿Es la válvula Ahmed superior al implante Baerveldt como derivación acuosa para el manejo del glaucoma? / ¿Es la válvula Ahmed superior al implante Baerveldt como derivación acuosa para el manejo del glaucoma? / Is Ahmed valve superior to Baerveldt implant as an aqueous shunt for the treatment of glaucoma?

Pimentel, Eduardo; Schmidt, Jimena.
Medwave; 18(5): e7239, 2018 Sep 07.
Artigo em Espanhol, Inglês | MEDLINE | Set 2018 | ID: mdl-30240388
Resumo: INTRODUCTION: Aqueous shunt has emerged as an alternative technique to trabeculectomy, considered the standard for glaucoma surgery. Currently, it is mainly indicated after failure of trabeculectomy or in glaucoma with high risk of failure. The Ahmed valve and the Baerveldt implant are the most commonly used aqueous shunts. However, it is not clear whether there are differences between them. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified five systematic reviews including 10 studies overall, of which two were randomized trials. We concluded the Ahmed valve probably achieves a lower decrease in intraocular pressure, might lead to less qualified success and probably needs more reinterventions than the Baerveldt implant. Regarding safety profile, the Ahmed valve is not clearly superior or inferior to the Baerveldt implant.