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Updated: Aug 15, 2026
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Follow-up of the original cohort with the Ahmed glaucoma valve implant
F Topouzis1, A L Coleman, N Choplin
1Jules Stein Eye Institute, University of California, Los Angeles, School of Medicine, 90095-7004, USA.
Insights
The Ahmed glaucoma valve shows comparable long-term performance to other glaucoma drainage devices. However, corneal complications like decompensation or graft failure are the most frequent adverse outcomes after 12 months.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Devices
Background:
- Glaucoma is a leading cause of irreversible blindness worldwide.
- The Ahmed glaucoma valve is a device used to manage complex glaucoma cases.
- Previous studies reported short-term outcomes of the Ahmed glaucoma valve.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of the Ahmed glaucoma valve implant.
- To analyze outcomes in patients with complicated glaucoma who received the implant.
- To identify long-term complications associated with the Ahmed glaucoma valve.
Main Methods:
- A multicenter study analyzed 60 eyes with Ahmed glaucoma valve implants.
- Failure was defined by specific intraocular pressure ranges, vision loss, or additional surgery.
- Corneal complications were included as a criterion for failure in some analyses.
Main Results:
- Mean follow-up was 30.5 months.
- When corneal complications were included, 43% of eyes were considered failures.
- Excluding corneal complications, failure rate was 21.5%, with most late failures due to corneal issues.
Conclusions:
- The Ahmed glaucoma valve demonstrates long-term performance comparable to other glaucoma drainage devices.
- Corneal decompensation or graft failure emerged as the most common adverse event after one year.
- Further research is necessary to determine the cause of post-implantation corneal problems.
Purpose:
To study the long-term results of the Ahmed glaucoma valve implant in patients with complicated glaucoma in whom short-term results have been reported.
Methods:
In this multicenter study, we analyzed the long-term outcome of a cohort of 60 eyes from 60 patients in whom the Ahmed glaucoma valve was implanted. Failure was characterized by at least one of the following: intraocular pressure greater than 21 mm Hg at both of the last two visits less than 6 mm Hg at both of the last two visits, loss of light perception, additional glaucoma surgery, devastating complications, and removal or replacement of the Ahmed glaucoma valve implant. Devastating complications included chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis, and phthisis bulbi; we also report results that add corneal complications (corneal decompensation or edema, corneal graft failure) as defining a devastating complication.
Results:
The mean follow-up time for the 60 eyes was 30.5 months (range, 2.1 to 63.5). When corneal complications were included in the definition of failure, 26 eyes (43%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 76%, 68%, 54%, and 45%, respectively. When corneal complications were excluded from the definition of failure, 13 eyes (21.5%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 87%, 82%, 76%, and 76%, respectively. Most of the failures after 12 months of postoperative follow-up were because of corneal complications.
Conclusions:
The long-term performance of the Ahmed glaucoma valve implant is comparable to other drainage devices. More than 12 months after the implantation of the Ahmed glaucoma valve implant, the most frequent adverse outcome was corneal decompensation or corneal graft failure. These corneal problems may be secondary to the type of eyes that have drainage devices or to the drainage device itself. Further investigation is needed to identify the reasons that corneal problems follow drainage device implantation.
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