Implante de válvula de Ahmed. Nuestra experiencia 1995-2003

Abstract

To evaluate the indications, results and complications of the Ahmed drainage device implanted between January 1995 and December 2003. A retrospective study of 70 eyes in 65 patients. We analysed: the indications for surgery; the preoperative intraocular pressure (IOP), the postoperative IOP at 1 and 3 months, 1, 2 and 3 years after surgery; and the short and long term postoperative complications. We defined an absolute success as an IOP between 5 and 21 mmHg without glaucoma medications, relative success the same IOP levels whilst taking glaucoma medications and failure as an IOP of less than 5 and more than 22 mmHg. The most frequent indications for use of the drainage device were: neovascular glaucoma (45.7%), no response to other glaucoma surgery (20%), aphakic glaucoma (10%) and traumatic glaucoma (8.5%). Mean preoperative IOP was 39 mmHg. Mean postoperative IOP was: 19.7 mmHg (1 month), 21.6 mmHg (3 months), 19.6 mmHg (1 year), 18 mmHg (2 years) and 18.6 mmHg (3 years). The most frequent early complications were athalamia and hiphema. The most frequent late complications were tube or body valve extrusion and fibrotic reaction around the valve. Both the indications and success rates are similar to those previously reported. Visual acuity assessment is not of value in this group of patients because of their multiple associated ophthalmic pathologies.