Clinical Experience with the Ahmed Glaucoma Valve

ABSTRACT

The purpose of this study is to assess clinical outcomes of the patients who underwent Ahmed glaucoma valve implantation. Twelve eyes of 11 patients underwent Ahmed valve implantation for intractable glaucoma unresponsive to conventional management from March 1997 to April 1998 at department of ophthalmology of Kangbuk Samsung Hospital and had minimum follow-up of three months. Success(survival)was defined as an intraocular pressure(IOP)between 6 and 21 mmHg and with no additional glaucoma surgery, phthisis, implant removal, or loss of light perception. The mean follow-up period was 8 months(range, 3-17 months). There were 7 neovascular glaucomas, 3 secondary angle close glaucomas and 2 juvenile open angle glaucomas. The postoperative 1 year cumulative survival rate (Kaplan-Meier survival analysis)was 83. 3%. High survival rate was shown in secondary angle close glaucoma and JOAG(100%). The survival rate was not affected by sex, age, preoperative IOP, preoperative diagnosis, or number of preoperative glaucoma medications. There was failure in 2 eyes. One eye had qualified success by secondary Ahmed valve implantation. In the other eye, the tube in anterior chamber was too short and was plugged by blood clot and inflammatory membrane. This patient could not be reoperated due to poor general condition. Complications were hyphema and hypotony, and they were well controlled. Ahmed valve implantation in patients with intractable glaucoma may offer a better chance of surgical success.