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Long-term outcomes of Ahmed ClearPath in childhood glaucoma: four-year results
Abdelrahman M Elhusseiny1, Mohamed S Sayed2, Mohamed M Khodeiry3
1Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
The Ahmed ClearPath (ACP) device effectively manages childhood glaucoma long-term, significantly reducing intraocular pressure and medication needs with a high success rate and excellent safety profile.
Area of Science:
- Ophthalmology
- Pediatric Glaucoma Management
- Surgical Devices
Background:
- Childhood glaucoma presents unique challenges for long-term intraocular pressure (IOP) control.
- Valveless glaucoma drainage devices offer an alternative surgical approach.
Purpose of the Study:
- To assess the long-term efficacy and safety of the Ahmed ClearPath (ACP) valveless glaucoma drainage device in pediatric glaucoma patients.
Main Methods:
- Retrospective review of medical records for patients ≤18 years old with at least 4 years of follow-up after ACP implantation.
- Key outcome measures included IOP, medication reduction, success rate, and complications.
Main Results:
- Mean IOP significantly decreased from 32.2 mmHg preoperatively to 16.1 mmHg at 4 years (P < 0.001).
- Glaucoma medication use was significantly reduced, with 5 eyes achieving complete success off medication.
- High success rates were maintained long-term (79% at 4 years) with no vision-threatening complications.
Conclusions:
- The ACP device provides effective long-term IOP control in childhood glaucoma.
- It demonstrates a favorable safety profile and reduces the need for glaucoma medications.
- ACP implantation is a successful surgical option for managing pediatric glaucoma.
Purpose:
To evaluate the long-term outcomes of the Ahmed ClearPath (ACP) valveless glaucoma drainage device in childhood glaucoma.
Methods:
In this multicenter study, the medical records of all patients ≤18 years of age who underwent ACP implantation and had at least 4 years of follow-up were reviewed retrospectively. The outcome measures included the success rate, reduction in intraocular pressure (IOP), the reduction in glaucoma medications, and the complication rate. Success was defined as achieving a postoperative IOP between 6-21 mm Hg, with or without glaucoma medications, without the need for additional glaucoma surgeries, and without vision-threatening complications.
Results:
Nineteen eyes of 17 children were included, with a mean follow-up of 52.4 ± 7.2 months. The mean IOP significantly decreased from 32.2 ± 4.4 mm Hg preoperatively to 14.2 ± 3.7 mm Hg at 1 year, 15.3 ± 4 mm Hg at 2 years, 16 ± 3.8 mm Hg at 3 years, and 16.1 ± 3.1 mm Hg at 4 years (P < 0.001 for all). The median number of glaucoma medications was significantly reduced from 2.5 preoperatively to 1 from year 1 to year 4 postoperatively. Success rates were 90% at 1 year, 84% at 2 years, 79% at 3 years, and 79% at 4 years. At the final follow-up visit, 5 eyes were off glaucoma medications (complete success). No serious vision-threatening complications occurred in any of our patients.
Conclusions:
The ACP glaucoma drainage device demonstrated effective long-term control of IOP, reduction in glaucoma medications, and a favorable success rate and safety profile in childhood glaucoma.
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