April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Outcomes of Ahmed glaucoma valve implantationTM in refractory pediatric glaucoma.
Author Affiliations & Notes
  • SIRISHA Senthil
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Paaraj Dave
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Avik Roy
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Harsha Rao
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Anil K Mandal
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Chandra S Garudadri
    Glaucoma, L V Prasad Eye Institute, Hyderabad, India
  • Footnotes
    Commercial Relationships SIRISHA Senthil, None; Paaraj Dave, None; Avik Roy, None; Harsha Rao, None; Anil Mandal, None; Chandra Garudadri, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3185. doi:https://doi.org/
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      SIRISHA Senthil, Paaraj Dave, Avik Roy, Harsha Rao, Anil K Mandal, Chandra S Garudadri; Outcomes of Ahmed glaucoma valve implantationTM in refractory pediatric glaucoma.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3185. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To report the efficacy and safety of Ahmed Glaucoma Valve TM (AGV) implantation in the management of refractory pediatric glaucoma.

Methods: We retrospectively reviewed 45 eyes of 38 subjects with age ≤16 years who underwent implantation of AGV between 2009 and 2013 for refractory pediatric glaucoma by a single surgeon and had a minimum follow up of 6 months. Primary outcome measure was cumulative probability of success, defined as intraocular pressure (IOP) >5 and ≤21 mm Hg on 2 consecutive visits, 3 months after surgery, in the absence of vision threatening complications related to surgery or loss of light perception.

Results: The median age at AGV implantation was 3.5 years (inter quartile range, IQR: 2, 12). There were 25 male and 13 female subjects. The median follow up was 14 months (IQR, 8, 23 months). The mean IOP significantly reduced from 31.6±7.3 mm Hg before surgery to 14.8±5.2 mm Hg at last follow up (P<0.0001). The number of topical antiglaucoma medications reduced from a mean of 3.3±0.8 before surgery to 1.7±1.3 at last follow up (P<0.0001). Visual acuity remained stable or improved in 77% of the eyes. The cumulative probability of success was 87% at one year and 83% at 2 years. Twenty-three eyes (51%) developed hypertensive phase (HP), median time to development of HP was 42 days (31, 92) after surgery. Tube related complications requiring intervention, were noted in 9 (20%) eyes. One eye with recurrent tube erosion developed endophthalmitis needing tube removal and vitrectomy with intraocular antibiotics. Among the risk factors studied, the height of IOP in hypertensive phase (hazard ratio: 1.22, p=0.05), number of previous intraocular surgeries (hazard ratio: 2.79, p=0.009) was significantly associated with failure.

Conclusions: The cumulative probability of success following AGV implantation in refractory pediatric glaucoma was 87% and 83% at the end of one and two years respectively. One third of the eyes had complications; half of these requiring interventions and one eye had a vision threatening complication.

Keywords: 568 intraocular pressure  
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