To compare the safety and efficacy of trabeculectomy using mitomycin C (MMC) with Ahmed valve implantation in pseudophakic glaucomatous eyes.

We retrospectively reviewed the medical records of 68 pseudophakic glaucoma patients (68 eyes) who had undergone trabeculectomy with MMC (group T, 41 eyes) or Ahmed valve implantation (group A, 27 eyes). Intraocular pressure reduction rates, cumulative probabilities of surgical success, and postoperative complications were compared between two groups. Also, risk factors for surgical failures were analyzed.

Intraocular pressure levels at postoperative 12 months were significantly lower in group T (13.8±5.1 mmHg) than in group A (19.6±6.4 mmHg, p=0.001). Cumulative probabilities of surgical success at postoperative 12 months were significantly higher in group T (95.0%) than in group A (66.2%, p=0.000). No significant differences were noted in the occurrences of complications except hyphema in two groups. We found that a younger age (≤50 years) and Ahmed valve implantation were significant risk factors for surgical failures.

Trabeculectomy with MMC can be more effective and preferable as a primary surgical option over Ahmed valve implantation for pseudophakic glaucomatous eyes.