April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Use and Safety of the Ahmed Aqueous Shunt (FP-7) for the Management of Pediatric Glaucoma
Author Affiliations & Notes
  • Dilshad Contractor
    The Vision Center, Childrens Hospital of Los Angeles, Los Angeles, CA
  • Bibiana Jin Reiser
    The Vision Center, Childrens Hospital of Los Angeles, Los Angeles, CA
    Ophthalmology, University of Southern California, Los Angeles, CA
  • Yohko Murakami
    Ophthalmology, University of Southern California, Los Angeles, CA
  • Footnotes
    Commercial Relationships Dilshad Contractor, None; Bibiana Reiser, None; Yohko Murakami, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3186. doi:https://doi.org/
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      Dilshad Contractor, Bibiana Jin Reiser, Yohko Murakami; The Use and Safety of the Ahmed Aqueous Shunt (FP-7) for the Management of Pediatric Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3186. doi: https://doi.org/.

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

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Abstract
 
Purpose
 

To analyze the efficacy and safety of the Ahmed Aqueous Shunt model FP-7 in the treatment of pediatric glaucoma.

 
Methods
 

A retrospective chart review was conducted on patients with a diagnosis of pediatric glaucoma who underwent Ahmed Aqueous Shunt FP-7 implantation for medically uncontrolled intraocular pressure (IOP) between the years of 2006 and 2012 at Childrens Hospital of Los Angeles. (Table 1). 41 eyes of 30 patients were analyzed. Outcome measures were control of IOP below 22 mmHg, number of antiglaucoma medications used to achieve a target pressure of 21, and postoperative complications. Intraocular pressure measurements were obtained in a method appropriate for age (iCare rebound tonometer, Tonopen, or Goldman applanation). Postoperative intraocular pressures were analyzed with Kaplan-Meier survival curves to follow shunt failure over time. (Figure 1). All values were analyzed for statistical significance.

 
Results
 

The postoperative follow-up period averaged 26.3 ± 15.7 months (range, 1 to 57 months). At last follow up, IOP was controlled in 24 eyes (58.5%), 5 of which did not need antiglaucoma therapy. Average number of glaucoma medications were 3.9 ± 1.2 preoperatively and 2.3 ± 1.7 postoperatively. Average IOP decreased from 31.8 ± 4.5 mmHg preoperatively to 21.6 ± 9.9 postoperatively. (P < 0.0001). There were 11 (26%) complications noted to be directly related to the shunt. 10 of the 41 eyes underwent a revision of the tube due to malpositioning as indicated by decreased function or metaplasia of the cornea. 1 eye in a high myope with juvenile open angle glaucoma (JOAG) had shallowing of the AC due to choroidal effusions that resolved spontaneously.

 
Conclusions
 

Ahmed Aqueous Shunt (FP-7) implantation decreased IOP and number of glaucoma medications in the setting of pediatric glaucoma. However, due to the number of complications, the decision to implant must be made judiciously and patients should be followed closely to assess tube position and revise the tube as needed.

 
 
Table 1: Demographics
 
Table 1: Demographics
 
 
Figure 1. Kaplan-Meier Analysis
 
Figure 1. Kaplan-Meier Analysis
 
Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications  
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