Results of Ahmed glaucoma valve implantation in primary congenital glaucoma

Abstract

To evaluate the outcome of Ahmed glaucoma valve (AGV) implantation in primary congenital glaucoma (PCG). The medical records of patients with PCG refractory to trabeculotomy and medical therapy who had undergone AGV implantation with a minimum follow-up of 6 months were retrospectively reviewed. The primary outcome measure was cumulative probability of success, defined as intraocular pressure (IOP) of 6-21 mm Hg, with or without medication, and no serious complications, additional glaucoma surgery, or loss of light perception. A total of 33 eyes of 22 children with a mean age (and standard deviation) of 2.7 ± 3.1 years were included. The patients had a mean follow-up time of 32.6 ± 18.3 months. The mean IOP was 32.8 ± 7.3 mm Hg preoperatively and 16.8 ± 4.0 mm Hg postoperatively. The number of glaucoma medications was 2.5 ± 0.7 preoperatively and 2.2 ± 0.7 postoperatively. The cumulative probability of success (and standard error) was 97% ± 3.0% in the 1st year, 85% ± 7.0% in the 2nd year, and 56% ± 14.8% in the 5th year. When only the first operated eye per patient was included, the cumulative probability of success was 96% ± 4.4% in the 1st and the 2nd years and 72% ± 15.3% in the 5th year. Major complications comprised tube-endothelial touch (3 eyes), cataract (2 eyes), shunt extrusion (1 eye), and retinal detachment (1 eye). AGV implantation in patients with PCG offers moderate success in controlling the IOP with a low rate of complications. Most continued to require medications.