Ahmed valves as a primary surgical procedure for paediatric glaucoma

Session Details

Session Title: Glaucoma

Session Date/Time: Monday 09/10/2017 | 08:00-10:30

Paper Time: 08:12

Venue: Room 4.1

First Author: : W.Astle CANADA

Co Author(s): :    E. Sanders                    

Abstract Details

Purpose:

To evaluate the efficacy of Ahmed Valve Implants as a primary option in the control of pediatric glaucoma

Setting:

Alberta Children’s Hospital operating room and Vision Clinic. Calgary, Alberta Canada.

Methods:

A retrospective case series was completed including 68 eyes of 49 children with congenital (29 eyes), or developmental glaucoma (39 eyes) who underwent primary glaucoma surgery with an Ahmed Valve implant. No previous glaucoma surgery other than the Ahmed valve had been undertaken previously at the Alberta Children’s Hospital. 23 of 68 eyes had glaucoma surgery elsewhere with the primary Ahmed Valve surgery at the Alberta Children’s Hospital. Success was defined as a reduction of the intraocular pressure (IOP) to less than 22 mm Hg with or without medications at the last two follow up visits.

Results:

Mean pre-operative IOP was 32.91 mm Hg (n=68, r=13–55), at year 1, was17.64 mm Hg (n=38) and 18.21 mm Hg at year 10 (n = 13). Results were similar for congenital and developmental glaucoma. 63 of 69 eyes were under IOP control with one surgery. 4 eyes underwent secondary goniotomies, and 3 eyes had a second Ahmed valve for control. There was a 8.69 % re-operation rate over 10 years. 5 of 38 eyes (13%) required one topical medication for control at 3 years post-op and 3 of 13 eyes at 10 years post-op. No serious complications were encountered

Conclusions:

Ahmed valve surgery as a primary procedure is a viable alternative to more standard glaucoma operations for treatment of congenital and pediatric glaucoma. It represents a valuable tool in quickly regaining IOP control in these complex pediatric cases, without the need for multiple surgeries and prolonged exposure to loss of vision from poorer long term IOP control.

Financial Disclosure:

NONE