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Outcomes of Ahmed Glaucoma Valve Revision in Pediatric Glaucoma

Ahmed Mansour Al-Omairi1, Aliah H Al Ameri1, Sami Al-Shahwan1

  • 1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

American Journal of Ophthalmology
|September 18, 2017
PubMed

Insights

Ahmed glaucoma valve (AGV) revision in children shows high short-term success but a significant decrease in efficacy over time. Long-term outcomes for pediatric glaucoma surgery require further investigation.

Area of Science:

  • Ophthalmology
  • Pediatric Glaucoma Surgery
  • Glaucoma Device Management

Background:

  • Encapsulation of the Ahmed glaucoma valve (AGV) plate frequently causes elevated intraocular pressure (IOP) postoperatively, particularly in pediatric patients.
  • While AGV revision outcomes in adults are documented, data for children remain limited.

Purpose of the Study:

  • To evaluate the outcomes of Ahmed glaucoma valve revision surgery in children.
  • To assess the efficacy and complications associated with AGV revision in a pediatric population.

Main Methods:

  • A retrospective cross-sectional study involving a chart review of patients under 15 years old who underwent AGV revision.
  • Minimum follow-up of 6 months, measuring IOP reduction, medication use, survival rates, and complications.
  • Complete success defined as IOP ≤ 21 mm Hg without medication; qualified success as IOP ≤ 21 mm Hg with medication.

Main Results:

  • 44 eyes were analyzed, primarily with primary congenital glaucoma (88.6%). Mean age was 6.7 years, with a median follow-up of 12 months.
  • Postoperative IOP decreased from a mean of 30.4 mm Hg to 24.9 mm Hg at 6 months.
  • Complete success rates declined from 100% at 1 month to 5.5% at 2 years. Qualified success rates showed approximately 50% survival at 1 year and 16% at 2 years, with a median survival time of 14 months. Recurrence of encapsulation was the most common complication (15.9%).

Conclusions:

  • AGV revision in children demonstrates high initial success rates.
  • However, the efficacy of AGV revision significantly diminishes with longer follow-up periods in pediatric glaucoma patients.
Abstract

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