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