The Ahmed drainage implant in the treatment of pediatric glaucoma

Purpoe To report the afety and efficacy of Ahmed Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, California, UA) implantation for the management of pediatric glaucoma in the early and intermediate follow-up period. Deign Conecutive interventional cae erie. Method A retropective chart review wa conducted on 60 eye (44 patient, age range at urgery 1.5 month to 16 year, average 6 ± 4.9 year), with pediatric glaucoma that underwent Ahmed Glaucoma Valve implantation for medically uncontrolled intraocular preure (IOP) between the year 1995 and 2000. Outcome meaure were control of IOP below 21 mm Hg, the need for antiglaucoma medication after urgery, and lo of 2 or more line of nellen acuity. Complication were monitored. Reult The potoperative follow-up period for each eye averaged 24.3 ± 16 month (range, 3 to 60 month). At lat follow-up, IOP wa controlled in 44 eye (73%), 11 of which did not need antiglaucoma therapy. Kaplan-Meier life-table analyi howed probability of ucce with or without medication of 93% (95% confidence interval [CI], 86%–100%), 86% (95% CI, 77%–96%), 71% (95% CI, 59%–87%), and 45% (95% CI, 28%–80%) after 12, 24, 36, and 48 month of follow-up. Average IOP decreaed from 32.8 ± 6.2 before urgery to 16.6 ± 8.0 potoperatively (P < .0001). The average number of medication ued decreaed from 4.4 ± 1.97 to 2.0 ± 2.0 (P < .0001). Kaplan-Meier urvival analyi did not reveal any difference in urvival profile related to pecific diagnoi of glaucoma, age (above or below 18 month), or prior urgery. Complication occurred in 30 eye (50%). Although mot reolved or were treated uccefully, four patient had evere viual lo during the follow-up. Uveiti wa a ignificant rik factor for tube expoure (Fiher exact tet, P = .006). Concluion Ahmed Glaucoma Valve implantation i an effective treatment for pediatric glaucoma, although patient frequently require antiglaucoma medication. However, a high rate of potentially ight-threatening potoperative complication warrant ongoing cloe follow-up.