The Ahmed Valve in refractory pediatric glaucoma Original Reearch Article

PURPOE: To evaluate the efficacy of the Ahmed Glaucoma Valve implant in pediatric patient with refractory glaucoma. METHOD: A retropective chart review wa conducted of 27 eye from 23 conecutive pediatric patient (younger than 18 year) with refractory glaucoma treated with Ahmed Glaucoma Valve implant placement. The main outcome meaure wa time after urgery without failure. ucce wa defined a an intraocular preure of 21 mm Hg or le without viually devatating complication or additional glaucoma urgery (excluive of tube reviion). Previou cycloablation, which wa preent in a ubet of eye, wa examined a a poible influence on potoperative intraocular preure control, glaucoma medication dependence, and urgical ucce. REULT: The median patient age wa 4.8 year (range, 0.3 to 16.8 year), with a follow-up of 3 to 31 month (mean, 12.6 ± 8.2 month). Intraocular preure wa reduced from a preoperative mean of 32.8 ± 7.5 mm Hg to 16.7 ± 5.4 mm Hg at 18 month potoperatively, with an overall ucce rate of 85.2% at lat follow-up. Cumulative probabilitie of ucce by Kaplan-Meier analyi were 90.6% at 12 month and 58.3% at 24 month. Compared with thoe that did not undergo previou cycloablation, eye that had undergone previou cycloablation had a lower mean potoperative intraocular preure at 3- and 6-month follow-up (P < .001 and P = .057, repectively) and required fewer glaucoma medication at potoperative examination time point up to 18 month (P ≤ .01 at each time point). Fifteen eye (56%) required glaucoma medication after urgery. The mot common complication wa corneal-tube contact, which occurred in five eye (18.5%). One eye with a wound leak required anterior chamber reformation. Retinal detachment occurred in one aphakic eye 2 year potoperatively, reulting in lo of viion. One eye with neovacular glaucoma required enucleation after an enlarging (preumably preexiting) medulloepithelioma wa dicovered. CONCLUION: Ahmed Glaucoma Valve implantation i a ueful therapy for the treatment of refractory pediatric glaucoma, and it may be afely ued in a ubgroup of eye with uncontrolled intraocular preure depite previou cycloablation procedure.1