The efficacy of Ahmed glaucoma valve implantation in the management of early stage of glaucoma secondary to blunt ocular trauma

Abstract

To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implantation in the early stage of glaucoma secondary to contusion injuries. A retrospective case series study. The study was made in 29 consecutive patients with glaucoma secondary to blunt trauma who were uncontrolled by multiple medications and then performed AGV implantations in less than 2 months after the trauma. The duration from injury to IOP elevation was 1 to 30 (6.10 ± 1.13) days. The time from injury to AGV implantation was 16 to 60 (40.03 ± 2.97) days. The patients were followed-up for a period of 6 to 42 (20.75 ± 1.66) months. The main outcome measures included intraocular pressure (IOP), visual acuity (VA), number of glaucomatous medications, intra- and postoperative complications. IOPs were analyzed by repeated measures analysis of variance, numbers of medication assessed by Kruskal-Wallis rank sum test followed by Bonferroni test, and VA comparison was performed using paired Student t-test. The absolute success rate was 86.21% and the conditional success rate was 13.79% after AGV implantation. Compared with pre-operation, the IOP was significantly(F = 124.09, P < 0.05) lowered at the last following-up of post-operation(42.59 ± 1.82)vs (15.12 ± 0.56) mm Hg(1 mm Hg = 0.133 kPa), the numbers of glaucomatous medications were significantly (H = 131.73, P < 0.05) reduced post-operatively (3.93 ± 0.15) vs (0.21 ± 0.12) species, and the VA was significantly (t = -3.466, P < 0.05) improved post-operatively (logMAR 0.40 vs logMAR 0.70). Two cases with shallow anterior chamber and three cases with hyphema were observed in the early stage after the surgery. No persistent hypotony, tube exposure or other serious complications were noted. AGV implantation is safe and effective in the management of intractable secondary glaucoma at early stage of contusion injuries.