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Abstract #94697 Published in IGR 22-2
Outcomes of Ahmed Glaucoma Valve Implantation in Eyes with Pediatric Keratoplasty
Senthil S; Rai M; Mohamed A; Bagga B; Ramappa MOphthalmology. Glaucoma 2022; 5: 94-100
PURPOSE: This study aimed to assess the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc.) implantation in eyes with pediatric keratoplasty and glaucoma. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Twenty-eight eyes of 25 children who underwent AGV after penetrating keratoplasty (PK) in 22 eyes and Descemet's stripping endothelial keratoplasty (DSEK) in 6 eyes were included. METHODS: Children (age ≤ 16 years) treated with AGV implant after keratoplasty from 2008 to 2019 with documented 6 months follow-up operated by a single surgeon were included. MAIN OUTCOME MEASURES: The primary outcome measure was AGV survival (intraocular pressure [IOP] between 6 and 21 mmHg with or without topical anti-glaucoma medications [AGMs]), and the secondary outcome measure was corneal graft survival. RESULTS: The mean age (± standard deviation) of patients at AGV surgery was 4.8 ± 0.7 years. The mean follow-up after AGV was 3.4 ± 0.5 years. The mean IOP decreased significantly from 31.5 ± 2.0 mmHg to 21.1 ± 2.3 mmHg at 6 months postsurgery (P < 0.001). The mean number of AGM decreased significantly (P < 0.001), and there was no change in mean visual acuity (P > 0.04 with Bonferroni correction). The cumulative survival probability of AGV was 92.9% ± 4.9% at 1 year and 81.3% ± 11.7% at 5 years. The AGV success was comparable between PK and DSEK eyes (P = 0.73). The cumulative probability of graft survival was 96.2% ± 3.8% at 1 year and 77.8% ± 9.1% at 5 years. The graft survival was also comparable between PK and DSEK eyes (P = 0.18). One eye needed tube trimming; none had tube or implant exposure. The major complication noted was corneal graft infection in 8 eyes (28.5%). CONCLUSIONS: In this cohort, the long-term AGV success and graft survival outcomes are satisfactory considering that AGV was performed in complex eyes with keratoplasty.
VST Glaucoma Centre, L V Prasad Eye Institute, Hyderabad, India. Electronic address: sirishasenthil@lvpei.org.
Full articleClassification:
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)