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Maria Lim, Daniel Neely, Kathryn Haider, David Plager; Efficacy and Safety of Ahmed Glaucoma Valve Implantation for Pediatric Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5669.
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© ARVO (1962-2015); The Authors (2016-present)
To review the efficacy and safety profile of Ahmed Glaucoma Valve (AGV) implantation in pediatric patients.
Retrospective chart review of 36 eyes in 36 patients who had undergone AGV implantation for refractory glaucoma. All patients were less than 18 years of age and had at least 6 months of follow up. Primary outcome measure was decrease in intraocular pressure (IOP) from baseline. Need for subsequent glaucoma surgery or occurrence of vision threatening complications were deemed failures.
Mean age at time of AGV implantation was 6.8 years (range, 0.3-17.7) with average follow up of 4.8 years (range 0.5-10.5). Number of prior glaucoma procedures was 2.9 (range, 0-8). Mean IOP reduction was 19.7 mmHg from a baseline of 35.3 mmHg to 15.6 mmHg at time of last visit. Nine eyes (25%) had post-operative complications including postoperative flat anterior chambers (2), tube migration (2), prolonged hypotony (1), hypotony with vitreous hemorrhage (1), retinal detachment (1), implant exposure (1), and choroidal effusion (1).
The AGV is very successful at both short and long term lowering of IOP but secondary complications requiring additional surgical intervention are common. Nine eyes were surgical failures with mean time to failure of 4.43 years. Overall success rate of AGV implantation for pressure control without complications was 75%. While the AGV is a useful and frequently successful therapy, it is also accompanied by a significant rate of postoperative complications in pediatric patients and should be reserved for refractory cases of glaucoma.
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