Clinical experience with the Ahmed glaucoma valve implant in complicated glaucoma.
BACKGROUND
To assess clinical outcomes of the Ahmed glaucoma valve implant, an aqueous shunting device with a unidirectional valve mechanism, in eyes with refractory glaucoma.


METHODS
Consecutive patients with intractable glaucoma who underwent Ahmed glaucoma valve insertion were retrospectively reviewed. Only patients with a minimum of 6 months of follow-up were included. The presence of intraocular pressure (IOP) > or = 22 mmHg in the first 6 postoperative months was defined as a hypertensive phase (HP). This study included 19 eyes in 19 patients.


RESULTS
The mean preoperative IOP was 32.1 +/- 6.9 mmHg, with medication (mean times medication administered, 3.8 +/- 1.0; range, 0-3). The mean postoperative IOP was 7.8 +/- 2.2 mmHg on day 1, 11.3 +/- 4.4 mmHg at 1 week, 19.1 +/- 7.7 mm Hg at 1 month, 16.5 +/- 6.4 mmHg at 3 months, and 17.5 +/- 0.7 mmHg at 6 months, respectively. Twelve patients (63.2%) exhibited the HP. Nine patients (49.3%) experienced the HP at 1 month and 3 patients at 2 months after the operation. At the end of 6 months of follow-up, 11 patients (57.9%) who had exhibited the HP required additional anti-glaucoma medication to control the IOP (mean times medication was administered, 1.0 +/- 1.1; range, 0-2). Complications associated with the valve included hyphema in 1 case, choroidal effusion in 2 cases, iris plugging of the tube in 1 case, bleb encapsulation in 3 cases, and PK graft failure in 1 case. Postoperative hypotony resolved within 1 week.


CONCLUSIONS
The Ahmed glaucoma valve implant was safe and effective in this series. The hypertensive phase peaked in the first to second months after surgery.
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei. shiuchen@cgmh.org.tw
Shiu-Chen
SC
Wu
Samuel C M
SC
Huang
Ken-Kuo
KK
Lin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies