Clinical Results of Ahmed Glaucoma Implantation in Refractory Glaucoma

Kook, Michael S; Jeon, Seong Ki

Abstract

24 eyes of 20 patients with increased intraocular pressure(IOP) or glaucoma that were not medically controlled or those who failed with previous glaucoma surgeries underwent Ahmed glaucoma valve implantation with intraoperative mitomycin C application. Mean follow-up period was 4.5 months (2-9 months) and mean preoperative IOP was 38.0 +/- 11.5mmHg. Mean IOP at last visit was 16.5 +/- 6.2mmHg and it was significantly lower compared to preoperative IOP (p<0.0001). One eye (4.2%) showed IOP less than 5mmHg at first postoperative day. When surgical success was defined as IOP less than 22mmHg and greater than 4 mmHg for 2 months or longer, IOP lowered by at least 20% from preoperative values (in eyes with preoperative IOP less than 22mmHg), and no additional glaucoma surgery or visually devastating complications, cumulative probability of success at 7 months was 69.1%. Qualified success (defined as lOP less than 22mmHg and greater than 4mmHg at last visit) rate was 83.3%. Complete success (IOP controlled as above without medication) rate was 66.7%. The complications included temporary shallow anterior chamber in 3 eyes, choroidal detachment in 3 eyes, fibrous membrane formation in anterior chamber in 3 eyes, hyphema in 2 eyes, tube malposition in 1 eye, corneal decompensation in 1 eye and tube blockage in 1 eye. This study suggests that Ahmed glaucoma implant provides good IOP control without significant postoperative complications including immediate postoperative period, and its success rate is comparable to the other seton implants.