Results of Ahmed glaucoma valve implantation in primary congenital glaucoma.

PURPOSE: To evaluate the outcome of Ahmed glaucoma valve (AGV) implantation in primary congenital glaucoma (PCG).

METHODS: The medical records of patients with PCG refractory to trabeculotomy and medical therapy who had undergone AGV implantation with a minimum follow-up of 6 months were retrospectively reviewed. The primary outcome measure was cumulative probability of success, defined as intraocular pressure (IOP) of 6-21 mm Hg, with or without medication, and no serious complications, additional glaucoma surgery, or loss of light perception.

RESULTS: A total of 33 eyes of 22 children with a mean age (and standard deviation) of 2.7 ± 3.1 years were included. The patients had a mean follow-up time of 32.6 ± 18.3 months. The mean IOP was 32.8 ± 7.3 mm Hg preoperatively and 16.8 ± 4.0 mm Hg postoperatively. The number of glaucoma medications was 2.5 ± 0.7 preoperatively and 2.2 ± 0.7 postoperatively. The cumulative probability of success (and standard error) was 97% ± 3.0% in the 1st year, 85% ± 7.0% in the 2nd year, and 56% ± 14.8% in the 5th year. When only the first operated eye per patient was included, the cumulative probability of success was 96% ± 4.4% in the 1st and the 2nd years and 72% ± 15.3% in the 5th year. Major complications comprised tube-endothelial touch (3 eyes), cataract (2 eyes), shunt extrusion (1 eye), and retinal detachment (1 eye).

CONCLUSIONS: AGV implantation in patients with PCG offers moderate success in controlling the IOP with a low rate of complications. Most continued to require medications.