"Priming" Aids to Detect the Possible Dysfunction of the Ahmed Glaucoma Valve Devices

Simple priming of the implant is always suggested before Ahmed glaucoma valve (AGV) device implantation. This helps the two valve leaflets to get separated, which aids in smooth jet outflow of fluid from the tube outlet of AGV implant and is initiated only after the priming.

To detect the anterior fluid leak and possible dysfunction of the AGV implant by the simple priming procedure.

Standard priming of the implant was carried out with a 5 cc syringe using a 27-gauge cannula under the operating microscope; normally, jet flow of fluid at the valve outlet indicates implant was in good condition and can be implanted. But in this video, partial flow at the valve outlet and reflux of fluid was noted anteriorly at the tube valve junction, after a few seconds of initial priming, which suggests defection in the AGV implant.

Intraoperatively, in our experience, over almost 20 years, we have found three faulty devices. The first and only one postoperative experience we had was with the child with acute proptosis at 5 weeks post implant.[1] This video highlights the importance of the simple priming procedure that should be done under a surgical microscope with cautious observation in identifying any dysfunction in the AGV devices.

https://youtu.be/cr1sBo03jiM.