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[Ahmed drainage device implant. Our experience between 1995 and 2003]
F J Montañez1, E Laso, M Suñer
1Servicio de Oftalmología, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, España. fjmontac@hotmail.com
Insights
The Ahmed drainage device effectively lowers intraocular pressure (IOP) for various glaucoma types. While complications like athalamia and hiphema occurred, success rates for glaucoma surgery were comparable to prior studies.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Devices
Background:
- Glaucoma management often requires surgical intervention when medical therapy is insufficient.
- Glaucoma drainage devices offer a surgical option for complex or refractory cases.
- The Ahmed drainage device is one such implant used to control intraocular pressure.
Purpose of the Study:
- To evaluate the indications for Ahmed drainage device implantation.
- To assess the surgical outcomes, including intraocular pressure (IOP) control.
- To identify and analyze early and late postoperative complications.
Main Methods:
- Retrospective study of 70 eyes in 65 patients who received the Ahmed drainage device.
- Analysis of indications for surgery, preoperative and postoperative IOP measurements at various time points (1 month to 3 years).
- Categorization of outcomes into absolute success (IOP 5-21 mmHg without medication), relative success (IOP 5-21 mmHg with medication), and failure (IOP <5 or >22 mmHg).
Main Results:
- Neovascular glaucoma was the most common indication (45.7%), followed by failed prior glaucoma surgery (20%).
- Mean preoperative IOP of 39 mmHg decreased significantly postoperatively, stabilizing around 18-21 mmHg from 1 month to 3 years.
- Common early complications included athalamia and hyphema; late complications involved tube/valve extrusion and fibrotic reactions.
Conclusions:
- The indications and success rates for the Ahmed drainage device align with previous research.
- Visual acuity is not a reliable outcome measure in patients with multiple ophthalmic comorbidities.
- The Ahmed drainage device demonstrates efficacy in managing complex glaucoma cases.
Purpose:
To evaluate the indications, results and complications of the Ahmed drainage device implanted between January 1995 and December 2003.
Materials And Methods:
A retrospective study of 70 eyes in 65 patients. We analysed: the indications for surgery; the preoperative intraocular pressure (IOP), the postoperative IOP at 1 and 3 months, 1, 2 and 3 years after surgery; and the short and long term postoperative complications. We defined an absolute success as an IOP between 5 and 21 mmHg without glaucoma medications, relative success the same IOP levels whilst taking glaucoma medications and failure as an IOP of less than 5 and more than 22 mmHg.
Results:
The most frequent indications for use of the drainage device were: neovascular glaucoma (45.7%), no response to other glaucoma surgery (20%), aphakic glaucoma (10%) and traumatic glaucoma (8.5%). Mean preoperative IOP was 39 mmHg. Mean postoperative IOP was: 19.7 mmHg (1 month), 21.6 mmHg (3 months), 19.6 mmHg (1 year), 18 mmHg (2 years) and 18.6 mmHg (3 years). The most frequent early complications were athalamia and hiphema. The most frequent late complications were tube or body valve extrusion and fibrotic reaction around the valve.
Conclusions:
Both the indications and success rates are similar to those previously reported. Visual acuity assessment is not of value in this group of patients because of their multiple associated ophthalmic pathologies.
