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Long-term outcomes of the Ahmed glaucoma valve surgery in childhood glaucoma
Alaa Mofti1, Amjad Alharbi2, Marya Alsuhaibani2
1Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Insights
Ahmed glaucoma valve (AGV) surgery shows high short-term success in childhood glaucoma but poor 10-year outcomes. Younger age and secondary glaucoma indicate a more challenging prognosis for this vision-saving procedure.
Area of Science:
- Ophthalmology
- Pediatric Glaucoma Management
- Surgical Outcomes
Background:
- Childhood glaucoma presents unique challenges in intraocular pressure management.
- Ahmed glaucoma valve (AGV) implantation is a common surgical option for refractory pediatric glaucoma.
Purpose of the Study:
- To evaluate the long-term success rates of Ahmed glaucoma valve (AGV) surgery in children with early-onset glaucoma.
- To identify factors associated with surgical success or failure in this pediatric population.
Main Methods:
- A retrospective review of 178 children (one eye each) with primary congenital or secondary childhood glaucoma who underwent AGV surgery over 10 years.
- Surgical failure was defined by postoperative intraocular pressure >21 mm Hg, need for reoperation, or vision loss to no light perception.
Main Results:
- The overall success rate of AGV surgery was 92% at 1 year, decreasing to 64% at 5 years and 36% at 10 years.
- Younger age at surgery (median 5.8 years) and secondary childhood glaucoma were significantly associated with lower success rates.
Conclusions:
- While AGV surgery offers good short-term control for childhood glaucoma, its 10-year efficacy is limited.
- Outcomes suggest that younger children and those with secondary glaucoma may experience more persistent or refractory disease, necessitating further research into optimized treatment strategies.
Purpose:
To report the rates of success of Ahmed glaucoma valve (AGV) surgery in early childhood glaucoma and factors associated with success.
Methods:
Children with primary congenital or early childhood secondary glaucoma who underwent AGV surgery over a 10-year period (one eye per child) at a single institution were identified. Surgical failure was defined as having one or more of the following: intraocular pressure of >21 mm Hg 3 months postoperatively, reoperation for glaucoma, and vision loss to no light perception.
Results:
A total of 178 patients were identified (median age, 5.8 ± 5.5 years): 125 with primary congenital and 53 with secondary childhood glaucoma. The success rate at 1 year was 92% (95% CI, 88%-96%); at 5 years, 64% (95% CI, 55%-73%); and at 10 years, 36% (95% CI, 25%-52%). Younger age at baseline (P = 0.003) and secondary childhood glaucoma (P = 0.045) were associated with lower success.
Conclusions:
The AGV is associated with high short-term success in children with primary congenital glaucoma, but the 10-year success rates are poor. Younger age and secondary childhood glaucoma may be associated with a more refractory outcome.
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