Long-term outcomes of the Ahmed valve implant as primary surgical treatment of glaucoma associated with Axenfeld–Rieger spectrum

Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : R.Rivero Gómez MEXICO

Co Author(s): :    U. Moreno-Paramo   E. Vidaurre-Mora   G. Lazcano-Gomez   J. Jimenez-Roman              

Abstract Details

Purpose:

Axenfeld-Rieger syndrome is a genetic disease characterized by alterations in the development of iridocorneal angle structures. Glaucoma occurs in up to fifty percent of patients with this diagnosis. To this day there are no studies that assess the implant of the Ahmed valve as primary surgical treatment of the disease. The objective of this study is to determine the long-term outcomes and the rate of success of the Ahmed valve implant in patients with glaucoma associated with Axenfeld-Rieger syndrome.

Setting:

Glacuoma service, Asociación para Evitar la Ceguera en México I.A.P. Dr. Luis Sánchez Bulnes Hospital, Mexico City.

Methods:

Retrospective cohort study. We reviewed all medical records of patients with diagnosed glaucoma associated with Axenfeld-Rieger syndrome treated primarily with Ahmed valve implant. We included patients diagnosed between 1998-2003 with follow-up up to five years. We obtained demographic data, systemic and ophtalmologic features, visual acuity (VA), number of drugs used, intraocular pressure (IOP), complications and additional surgery in each year from implant surgery. We defined total success as intraocular pressure less than twenty-one mmHg and a maximum of three drugs used to control IOP. Failure was defined as additional surgery needed to reduce IOP or complications that threatened vision.

Results:

Fifty eyes were included from thirty-two patients. Age at diagnosis was 11.07 ± 9.62 years. Preoperative VA (Logmar) was 1.36 ± 0.74 and postoperative 1.29 ± 0.75. The number of preoperative drugs was 2.88 ± 0.75, postoperative number of drugs was 2.20 ± 0.85 (P = 0.01) by the month 60 and 2.79 ± 1.02 (P> 0.9999) by the month 120. Preoperative IOP was 31.22 ± 6.58 mmHg and postoperative IOP was 15.9 ± 5.34 (P <0.0001). The cumulative probability of success was 80% to five years and 50% to ten years.

Conclusions:

Implant of the Ahmed valve as primary surgical treatment is an effective option to reduce long-term IOP in patients with glaucoma associated with Axenfeld-Rieger syndrome. The rate of success is very good at five years after surgery and fair at ten years after surgery. A life-time follow up is critical.

Financial Disclosure:

None