Korean J Ophthalmol.  2015 Apr;29(2):109-114. 10.3341/kjo.2015.29.2.109.

Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

• Lee N
• Ma KT
• Bae HW
• Hong S
• Seong GJ
• Hong YJ
• Kim CY

• KMID: 2363716
• DOI: http://doi.org/10.3341/kjo.2015.29.2.109

Abstract

PURPOSE
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.

Keyword

Ahmed valve implantation; Congenital glaucoma; Surgical outcomes; Trabeculectomy

MeSH Terms

Child, Preschool
Female
Follow-Up Studies
Glaucoma/congenital/physiopathology/*surgery
*Glaucoma Drainage Implants
Humans
Infant
Intraocular Pressure/*physiology
Male
Mitomycin/*adverse effects
Nucleic Acid Synthesis Inhibitors/adverse effects
Reoperation
Retrospective Studies
Time Factors
Trabeculectomy/*adverse effects/*methods
Treatment Failure
Treatment Outcome
*Visual Acuity
Mitomycin
Nucleic Acid Synthesis Inhibitors

Figure

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  Fig. 1 Kaplan-Meier survival curve showing the proportion of eyes in which the operation was successful over time after trabeculectomy or Ahmed glaucoma valve implantation.

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