title: Surgical results of trabeculectomy and Ahmed valve implantation following a previous failed trabeculectomy in primary congenital glaucoma patients.
abstract: OBJECTIVE
  To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy.
  
  
  METHODS
  A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C.
  
  
  RESULTS
  The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38).
  
  
  CONCLUSIONS
  There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. ; Department of Ophthalmology, Hallym Hospital, Incheon, Korea.
authors.forename: Naeun
authors.initials: N
authors.lastname: Lee
authors.affiliation: Jeil Eye Clinic, Suwon, Korea.
authors.forename: Kyoung Tak
authors.initials: KT
authors.lastname: Ma
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyoung Won
authors.initials: HW
authors.lastname: Bae
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Samin
authors.initials: S
authors.lastname: Hong
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Gong Je
authors.initials: GJ
authors.lastname: Seong
authors.affiliation: Noone Eye Hospital, Seoul, Korea.
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chan Yun
authors.initials: CY
authors.lastname: Kim
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D016685:Mitomycin / Q000009:adverse effects*; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000009:adverse effects* / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin
keywords: Ahmed valve implantation; Congenital glaucoma; Surgical outcomes; Trabeculectomy
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