Initial clinical experience with the Ahmed Glaucoma Valve implant in pediatric patients.

OBJECTIVE

To evaluate the Ahmed Glaucoma Valve implant, an aqueous shunting device with a unidirectional valve mechanism, in patients younger than 18 years.

DESIGN

Prospective case series.

SETTING

Tertiary care hospital.

PATIENTS

Twenty-one consecutive patients younger than 18 years. The median age of patients was 4.8 years (range, 0.23-17.9 years)

INTERVENTION

Placement of an Ahmed Glaucoma Valve implant between April 1992 and April 1994.

MAIN OUTCOME MEASURE

Time after surgery without failure. Success was defined as an average intraocular pressure less than 22 mm Hg for the last 2 follow-ups in eyes with preoperative intraocular pressure greater than 22 mm Hg, or an intraocular pressure that was lowered by at least 20% from preoperative values in eyes with preoperative intraocular pressure less than 22 mm Hg, and no additional glaucoma surgeries or visually devastating complications.

RESULTS

Cumulative probabilities of success at 12 and 24 months were 77.9% +/- 8.8% and 60.6% +/- 13.7%, respectively. One eye had a flat anterior chamber and suprachoroidal hemorrhage on the first postoperative day. No other eyes had flat or shallow anterior chambers that required reformation. In 3 eyes the implant extruded from underneath the conjunctiva and was removed. In 2 other eyes the average intraocular pressure for the last 2 follow-ups was greater than 22 mm Hg. In 1 eye with an intraocular pressure less than 22 mm Hg preoperatively, the intraocular pressure was not reduced by at least 20%, although the number of antiglaucoma medications was reduced.

CONCLUSION

The 12-and 24-month success rates of the Ahmed Glaucoma Valve implant are similar to those of other implants when used in a pediatric population.