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C. Foster, C. Kafkala, J.Y. Choi, A.Y. Hynes; Ahmed Valve Implantation for Uveitic Glaucoma in Children . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2824.
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Purpose:To evaluate the safety and efficacy of Ahmed valve implantation for the management of glaucoma associated with chronic uveitis in pediatric patients. Methods: A retrospective chart review was conducted of six pediatric patients (seven eyes) who underwent Ahmed valve implantation due to refractory uveitic glaucoma. The patients’ age at the time of Ahmed valve implantation ranged from 9 to 13 years old. The etiologies were juvenile idiopathic arthritis–related uveitis in four patients, intermediate uveitis in one child and sarcoid–related uveitis in one child. All children were treated with immunomodulatory drugs for their uveitis. The eyes were free of inflammation for at least one month before the operation in four cases. The other three cases were performed while mild inflammation (+1 cells or less) persisted, since there was rapidly progressing optic nerve or visual field changes. Intraocular pressure (IOP) reduction, preoperative and postoperative visual acuities, number of hypotensive medications required pre– and postoperatively, and complications associated with the operation were evaluated. Results: The follow–up duration varied from 6 to 60 months (average 36.8 months). The preoperative IOP ranged from 26 to 52 mm Hg (average 37 mm Hg). At the last postoperative visit recorded, all 7 eyes had IOPs between 9 and 18 mm Hg (average 12 mm Hg). The IOP reduction averaged 69.6%. The number of hypotensive agents was reduced by an average of 0.71 medicines per eye. The only complication observed was hemorrhagic choroidal detachment postoperatively in two eyes; both spontaneously resolved within one month. Conclusions: For children with good immunomodulatory control of their inflammation and appropriate follow–up, Ahmed valve implantation can be an effective and safe procedure for treating pediatric uveitic glaucoma.
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