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S. L. Hoki, J. C. Meier, J. C. Song; Ahmed Valve and Baerveldt Implants for Refractory Glaucoma in Pediatric Patients: A Single Surgeon Comparison. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3959.
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To compare the short-term success rates of Ahmed and complete Baerveldt drainage devices in pediatric glaucoma patients.
A retrospective review of charts was performed at Children’s Hospital Los Angeles on all Ahmed and Baerveldt implants placed by a single surgeon (JCS) in patients aged 0 to 18 years old. Of Baerveldt drainage devices implanted, only complete non-staged cases were included. Patients with a history of previous tube surgery or those without six-month post-operative clinical data were excluded from the study. Surgical failure was defined as an IOP less than 6 mm Hg or greater than 21 mm Hg, development of no light perception vision, additional glaucoma surgery, removal of drainage device, or devastating complications such as suprachoroidal hemorrhage, malignant glaucoma, endophthalmitis, retinal detachment, chronic hypotony, serous choroidal effusions requiring drainage or with a kissing appearance.
Ahmed valves placed into 12 eyes from 10 patients, and complete Baerveldt implants placed in 26 eyes of 24 patients, met our study criteria. The average pre-operative IOP was 35 ± 8 mm Hg for Baerveldt patients and 37 ± 8 mm Hg for Ahmed patients. The average six-month post-operative IOP was 17 ± 5 mm Hg for Baerveldt cases and 15 ± 4 mm Hg for Ahmed patients. 9/12 (75%) of Ahmed surgeries and 22/26 (85%) of Baerveldt surgeries were successful after six months based on our criteria.
In a single surgeon comparison of Ahmed and Baerveldt implants for intractable glaucoma in pediatric patients, we found similar IOP outcomes and success rates at six months of post-operative care. Complete Baerveldt implants are comparable to Ahmed devices for surgeons who prefer one non-staged surgery.
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