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Y. Ou, S. K. Law, A. L. Coleman, J. Caprioli; Outcomes of Ahmed Glaucoma Valve Implantation in Primary Congenital Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1246. doi: https://doi.org/.
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To evaluate the long-term efficacy of intraocular pressure (IOP) reduction and complications of Ahmed glaucoma valve implantation in children with primary congenital glaucoma.
The medical records of patients with primary congenital glaucoma who underwent single-plate Ahmed glaucoma valve (AGV) implantation with a minimum of six months of follow-up from 1995 to 2006 were reviewed. Patients with secondary diagnoses including aphakia, Sturge-Weber, uveitic glaucoma, aniridia, and anterior segment dysgenesis were excluded. Data regarding age, gender, race, eye laterality, prior surgical interventions, number of medications, IOP, surgical complications, and follow-up interval were collected. The primary outcome measure was cumulative probability of success defined as IOP greater than 5 mm Hg and less than 23 mm Hg without serious complications or loss of light perception. Kaplan-Meier survival analyses were used to assess outcomes and Cox’s proportional hazard regression analysis was used to identify risk factors for failure. The primary outcome was qualified success rate. Secondary outcomes included mean IOP, mean number of medications, surgical complications, and need for further glaucoma surgery.
Thirty eyes of 19 patients with primary congenital glaucoma that underwent single-plate AGV implantation were identified. The mean age of patients at the time of surgery was 1.82 +/- 2.6 years. The mean preoperative IOP was 28.4 +/- 6.7 mm Hg. Follow-up time was 54.4 +/- 48 months (range 8 to 165 months). The cumulative probability of success was 66%, 52%, and 43% at one, three, and five years, respectively. In univariate risk factor analyses, younger age (p = 0.03) and female sex (p = 0.003) were associated with increased risk of failure. The most common postoperative procedure was additional AGV implantation in 9 eyes (30%) followed by tube revision in 6 eyes (20%).
43% of single-plate AGV implantations in primary congenital glaucoma were considered successful after five years of follow-up. Younger age and female sex were statistically significant risk factors for failure.
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