title: Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries.
  
  
  METHODS
  Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications.
  
  
  RESULTS
  Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56-30.80) mm, corneal diameter was 14.71±1.07 (13.0-16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9-1.0), and IOP was 39.5±5.7 (30-55) mmHg. The mean follow-up time was 18.29±10.96 (5-44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001) postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan-Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases.
  
  
  CONCLUSIONS
  AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications.
authors.affiliation: State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Huang
authors.affiliation: State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Jialiu
authors.initials: J
authors.lastname: Lin
authors.affiliation: Center for Advanced Eye Care, Carson City, NV, USA.
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Institute of Child Health Policy, University of Florida, Gainesville, FL, USA.
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Chengguo
authors.initials: C
authors.lastname: Zuo
authors.affiliation: State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
keywords: Ahmed glaucoma valve; primary congenital glaucoma; surgical complication