Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.
OBJECTIVE
To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.


METHODS
Retrospective institutional case series.


RESULTS
Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) < or =22 mm Hg a mean of 7.2 m (SD 6.8) postoperatively. Cumulative probabilities of valve survival (IOP< or =22 mm Hg with or without medication) by Kaplan-Meier analysis were 73.8% and 63.3% at 12 months and 24 months, respectively.


CONCLUSIONS
Postoperative tube malpositioning that required surgical revision was common in this age group. Infectious endophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.
Almobarak
F
F
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Al-Mobarak
F
F
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Khan
A O
AO
D009877:Endophthalmitis / Q000209:etiology; D019544:Equipment Failure Analysis; D005260:Female; D005901:Glaucoma / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D008297:Male; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors