Risk factors for Visual Field Progression in patients with Adequate Intraocular Pressure Reduction after Ahmed valve implantation

Purpose: This study aimed to identify risk factors for visual field (VF) progression in glaucoma patients who underwent Ahmed Glaucoma Valve (AGV) implantation and achieved adequate intraocular pressure (IOP) reduction. Understanding these factors is vital for improving long-term outcomes. Methods: A retrospective observational study was conducted at XX Hospital, including glaucoma patients who underwent AGV implantation between October 2012 and January 2022. Patients were eligible if they achieved IOP <18 mmHg with up to two anti-glaucoma medications and had at least three follow-up VF tests. Logistic regression was used to identify factors associated with VF progression. Results: Among the 33 patients, 42.4% (14 eyes) showed VF progression. There was no significant difference in postoperative IOP between the progression and non-progression groups. Smoking was strongly associated with VF progression. Current smokers had a significantly higher risk (odds ratio [OR] = 9.333, 95% confidence interval [CI]: 1.653-52.685, P = 0.011), and past smokers also showed a significant association (P = 0.045). Conclusion: Smoking is a significant risk factor for VF progression in glaucoma patients after AGV implantation, even with adequate IOP control. Clinicians should assess smoking history and encourage smoking cessation to improve patient long-term outcomes. Further research with larger cohorts is needed to confirm these findings and explore additional risk factors.