To evaluate the course of the hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation and the effects of digital ocular massage.

A total of 131 eyes of 131 patients, who underwent AGV implantation surgery, were studied retrospectively. HP was defined as an IOP (intraocular pressure) ≥ 22 mm Hg within 6 months after surgery. Various clinical factors related to the occurrence of HP were analyzed. The HP group was compared to the non-HP group. Ocular massage was performed in patients showing acute elevation of IOP at a relatively early postoperative period, and the effects were compared with the non-massage group. The patients who received ocular massage were divided, based on its effects, and compared.

HP developed in 62.6% of the patients after AGV surgery, and the success rate was significantly lower in the HP group. HP occurred more often in males and in patients with high IOP before surgery. HP developed in 82 eyes at 3.3 weeks after surgery in average. Ocular massage was performed in 30 eyes that showed acute IOP increase. The amount of IOP reduction, compared to 1 month after surgery, was greater in massage group than no massage group from 2 months to 3 years after surgery. Successful IOP control by ocular massage was observed in 14 eyes (46.7%), and the success rate was higher in these patients than the patients who showed no significant IOP reduction by ocular massage. But, the difference was not significant ( p = 0.072).

HP is related to the final outcome of surgery. Digital ocular massage can be used as an effective method to control HP and prevent further glaucomatous damage.