Ahmed Glaucoma Valve Implantation with the Tube Placement in the Ciliary Sulcus: Short Term Results

Abstract Purpose: To evaluate the clinical outcomes of pseudophakic/aphakic eyes with uncontrolled glaucoma that underwent Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus.Methods: Medical records of the patients who underwent Ahmed glaucoma valve implantation through the ciliary sulcus, between December 2017 and June 2019, were reviewed retrospectively. Patients’ age, gender, glaucoma diagnosis, visual acuity, intraocular pressure levels and complications were recorded. Results: Forty-seven eyes of 43 patients with glaucoma were enrolled. The mean age was 54.5 ± 19.9 years (range, 7 - 88 years) at the time of surgery and the mean postoperative follow-up period was 7.9 ± 3.4 months (range, 3 -16 months). The mean preoperative intraocular pressure level was 35.2 ±6.8 mmHg (range, 25-55 mmHg) and it was found as 15.6 ± 5.4 mmHg (range, 9-33 mmHg) at last follow-up visit. Decrease in intraocular pressure level was statistically significant (P < 0.001). At last follow-up visit success was achieved in 41 eyes (87.2 %). Hyphema was the most common postoperative complication and developed in 11 eyes (23.4%) and resolved spontaneously in all of them within one month.Conclusion: In pseudophakic or aphakic eyes with uncontrolled glaucoma, placement of Ahmed glaucoma valve tube in the ciliary sulcus is a safe and effective procedure. Ciliary sulcus can be considered as a potential space during tube shunt surgery in eyes with high risk of tube-corneal touch or corneal decompensation.

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Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672118761332 ◽

2018 ◽

Vol 29 (1) ◽

pp. 44-51 ◽

Cited By ~ 9

Author(s):

Mohammad Pakravan ◽

Hamed Esfandiari ◽

Shahin Yazdani ◽

Azadeh Doozandeh ◽

Zahra Dastborhan ◽

...

Keyword(s):

Intraocular Pressure ◽

Success Rate ◽

Congenital Glaucoma ◽

Ahmed Glaucoma Valve ◽

Aphakic Glaucoma ◽

Group 2 ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation ◽

Group 1

Purpose: To evaluate the outcomes of Ahmed glaucoma valve implantation in refractory primary congenital glaucoma as well as primary procedure in aphakic glaucoma. Method: In this retrospective study, medical records of patients who underwent Ahmed glaucoma valve implantation for refractory glaucoma and aphakic glaucoma were reviewed. Primary outcome measures were the surgical success defined as intraocular pressure ≤21 mm Hg and decreased ≥20% and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity, and intraocular pressure. Results: A total of 62 eyes of refractory primary congenital glaucoma patients (group 1) and 33 eyes of aphakic glaucoma patients (group 2) were included in our study. Mean follow-up was 51 ± 33 months in group 1 and 49 ± 41 months in group 2 (p = 0.82). The cumulative probability of success was 90% in both groups at the first year; however, the success rate was 52.5% in group 1 and 71.5% in group 2 at 5 years’ follow-up visit. In group 1, the mean intraocular pressure ± standard deviation was 33.1 ± 8.6 mm Hg at the baseline and decreased to 17.1 ± 5.3 mm Hg at 1 year and 18.5 ± 6.4 at 3 years postoperatively (all p’s < 0.001). Corresponding values for group 2 were 28.9 ± 6.1, 15.2 ± 4.6, and 16.0 ± 5.9 mm Hg, respectively (all p’s < 0.001). The baseline number of glaucoma medications was 3 ± 0.7 that decreased to 2 ± 0.8 at final follow-up (p = 0.02). Conclusion: Ahmed glaucoma valve implantation has a moderate success rate in the management of refractory primary congenital glaucoma with an increased chance of tube-related complications. The surgical success rate is higher in case of primary Ahmed glaucoma valve implant for aphakic glaucoma with acceptable safety profile.

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Changes in Corneal Endothelial Cells after Ahmed Glaucoma Valve Implantation: 2-Year Follow-up

Yearbook of Ophthalmology ◽

10.1016/s0084-392x(10)79333-3 ◽

2010 ◽

Vol 2010 ◽

pp. 95-97

Author(s):

J.S. Myers

Keyword(s):

Endothelial Cells ◽

Ahmed Glaucoma Valve ◽

Corneal Endothelial Cells ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

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Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up

Acta Ophthalmologica ◽

10.1111/aos.12493 ◽

2014 ◽

Vol 93 (1) ◽

pp. e1-e6 ◽

Cited By ~ 13

Author(s):

Enyr S. Arcieri ◽

Jayter S. Paula ◽

Rodrigo Jorge ◽

Kleyton A. Barella ◽

Rafael S. Arcieri ◽

...

Keyword(s):

Intravitreal Bevacizumab ◽

Neovascular Glaucoma ◽

Efficacy And Safety ◽

Ahmed Glaucoma Valve ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

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Risk factors and outcomes of management of delayed suprachoroidal haemorrhage following Ahmed glaucoma valve implantation in children

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313804 ◽

2019 ◽

Vol 104 (1) ◽

pp. 115-120 ◽

Cited By ~ 1

Author(s):

Shantha Balekudaru ◽

Tamonash Basu ◽

Parveen Sen ◽

Pramod Bhende ◽

Vijaya Lingam ◽

...

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Congenital Glaucoma ◽

Ahmed Glaucoma Valve ◽

Retrospective Case ◽

Incidence Risk ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation ◽

Control Study

AimsTo assess the incidence, risk factors and outcomes of management of delayed suprachoroidal haemorrhage (DSCH) in children who had undergone Ahmed glaucoma valve implantation.MethodsA retrospective case-control study of eyes which developed DSCH in children <18 years of age who underwent surgery between January 2009 and December 2017 with a follow-up of at least 2 months was performed. Nine cases were compared with 27 age, gender and surgeon matched controls who had undergone surgery during this period.ResultsThe incidence of DSCH was 4.7% (95% CL 1.5% to 7.7%, 9 eyes of 191 children). There were no significant differences between cases and controls in baseline details except for the number of intraocular pressure (IOP) lowering medications (p=0.01) and follow-up period (p=0.001). Risk factors identified on univariate analysis (p≤0.1) were axial length (p=0.02), diagnosis of primary congenital glaucoma (p=0.05), postoperative hypotony (p=0.07) and aphakia (p=0.1). None of them were found to be significant on multivariate analysis. Five eyes, three with retinal apposition and two with retinal detachment, underwent surgical drainage. There were no significant differences in the outcomes of eyes which underwent drainage compared with those which did not. Failures, defined as IOP>18 mm Hg despite use of medications, loss of light perception, phthisis or removal of the implant were more frequent in cases (three eyes, 33.3%) compared with controls (four eyes, 14.8%) (p=0.002).ConclusionsNone of the risk factors analysed in our series proved to be significant. Failures were more common in eyes with choroidal haemorrhage, despite surgical intervention.

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