A Case of Ahmed Glaucoma Valve Implantation without Removal of the Anterior Chamber Lens

ABSTRACT

PURPOSE: To report the results of performing an Ahmed glaucoma valve implantation without removing the anterior chamber lens to treat secondary glaucoma. CASE SUMMARY: A 72-year-old male visited the hospital for imminent visual field loss in the left eye. At the time of the visit, he had a mild headache, and the intraocular pressure of the left eye was 38 mm Hg. The left eye had received anterior chamber lens insertion with iridectomy and the posterior capsule was ruptured. The vitreous protruded at the two o'clock site and adhered to the backside of the anterior chamber lens tilting it toward the temporal cornea. At the time of the visit, the maximum corrected vision of the left eye was 0.32. The patient was diagnosed with secondary glaucoma caused by the anterior chamber lens. Because the patient did not want to have the anterior chamber lens removed and the supporting area of the anterior chamber lens blocked the trabeculectomy and peripheral iridectomy sites, the authors performed an Ahmed glaucoma valve implantation instead. The outcome of Ahmed glaucoma valve implantation was evaluated through a preoperative and postoperative vision test and periodical corneal endothelial cell analysis. During the six months of postoperative follow-up, the vision was improved, intraocular pressure was stabilized, and corneal endothelial cells were maintained. CONCLUSIONS: When a patient requires glaucoma surgery for secondary glaucoma caused by an anterior chamber lens, an Ahmed implantation without lens removal may be an option which may carefully be considered. However, because of the possibility of subsequent complications, a longer follow-up period is necessary.