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Polypropylene vs silicone Ahmed valve with adjunctive mitomycin C in paediatric age group: a prospective controlled
1Faculty of Medicine, Cairo University, Cairo, Egypt. yasminemelsayed@yahoo.com
Insights
Silicone Ahmed glaucoma valves (AGV) offer superior intraocular pressure control and longer survival rates compared to polypropylene AGVs in children under 10 years old.
Area of Science:
- Ophthalmology
- Pediatric Glaucoma Management
Background:
- Paediatric glaucoma requires effective long-term management.
- Ahmed glaucoma valves (AGV) are commonly used devices for glaucoma surgery.
Purpose of the Study:
- To compare the efficacy and survival rates of silicone versus polypropylene Ahmed glaucoma valves (AGV) in children under 10 years of age.
Main Methods:
- Prospective study involving 50 eyes of 33 children with paediatric glaucoma.
- Eyes were implanted with either silicone or polypropylene AGV, with contralateral eyes used for comparison in bilateral cases.
Main Results:
- Silicone AGVs demonstrated significantly lower intraocular pressure (IOP) at 6 months, 1 year, and 2 years postoperatively.
- The silicone AGV group showed significantly longer average survival time and higher cumulative survival probability at 2 years.
- No significant differences in postoperative interventions or complications were observed between the groups.
Conclusions:
- Silicone AGVs provide better IOP control and longer device survival in paediatric glaucoma compared to polypropylene AGVs.
- Fewer antiglaucoma medications may be required with silicone AGVs.
- Silicone AGVs are a favorable option for managing glaucoma in children under 10 years old.
Purpose:
To compare the results of silicone and polypropylene Ahmed glaucoma valves (AGV) implanted during the first 10 years of life.
Methods:
A prospective study was performed on 50 eyes of 33 patients with paediatric glaucoma. Eyes were matched to either polypropylene or silicone AGV. In eyes with bilateral glaucoma, one eye was implanted with polypropylene and the other eye was implanted with silicone AGV.
Results:
Fifty eyes of 33 children were reviewed. Twenty five eyes received a polypropylene valve, and 25 eyes received a silicone valve. Eyes implanted with silicone valves achieved a significantly lower intraocular pressure (IOP) compared with the polypropylene group at 6 months, 1 year, and 2 years postoperatively. The average survival time was significantly longer (P=0.001 by the log-rank test) for the silicone group than for the polypropylene group and the cumulative probability of survival by the log-rank test at the end of the second year was 80% (SE: 8.0, 95% confidence interval (CI): 64-96%) in the silicone group and 56% (SE: 9.8, 95% CI: 40-90%) in the polypropylene group. The difference in the number of postoperative interventions and complications between both groups was statistically insignificant.
Conclusion:
Silicone AGVs can achieve better IOP control, and longer survival with less antiglaucoma drops compared with polypropylene valves in children younger than 10 years.
