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Outcomes of Silicone Ahmed Glaucoma Valve Implantation in Refractory Pediatric Glaucoma

Sirisha Senthil1, Kiranmaye Turaga1, Hasnat A Mohammed2

  • 1VST Glaucoma Center.

Journal of Glaucoma
|July 31, 2018
PubMed

Insights

Silicone Ahmed Glaucoma Valve (AGV) implantation effectively manages refractory pediatric glaucoma, showing high success rates in both primary congenital glaucoma and secondary pediatric glaucoma cases. Previous intraocular surgeries increase the risk of failure.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Management

Background:

  • Refractory pediatric glaucoma presents significant management challenges.
  • Glaucoma valve implantation is a surgical option for complex cases.
  • Outcomes in pediatric populations require specific evaluation.

Purpose of the Study:

  • To evaluate the efficacy and safety of Silicone Ahmed Glaucoma Valve (AGV) implantation.
  • To assess AGV outcomes in children with refractory pediatric glaucoma.
  • To compare results between primary congenital glaucoma (PCG) and secondary pediatric glaucoma (SPG).

Main Methods:

  • Retrospective analysis of 65 eyes from 53 children (≤16 years) undergoing AGV implantation (2007-2015).
  • Inclusion criteria: follow-up ≥6 months.
  • Success defined as intraocular pressure (IOP) between 5-21 mmHg; failure as repeat surgery or vision loss.

Main Results:

  • Overall success probability was 88% at 1 year, maintained up to 4 years.
  • Success rates were 91% for PCG and 83% for SPG (P=0.49).
  • Number of prior intraocular surgeries (HR 2.24) was a significant risk factor for failure (P=0.01). Tube-related complications occurred in 16%.

Conclusions:

  • Silicone Ahmed Glaucoma Valve implantation demonstrates a good success rate in refractory pediatric glaucoma.
  • Outcomes and complication rates were comparable between PCG and SPG.
  • The number of prior intraocular surgeries is a critical risk factor for AGV failure in pediatric patients.
Abstract

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