Clinical evaluation of FP-7/FP-8 Ahmed glaucoma valve implantation for childhood refractory glaucoma / 中华实验眼科杂志

ABSTRACT

Background Clinical study showed that FP-7/FP-8 Ahmed glaucoma valve implantation is effective and safe for the adult refractory glaucoma.However,it is welt-known that childhood glaucomatous eyes have different pathogenesis and protean clinical manifestations.So the efficacy of FP-7/FP-8 Ahmed glaucoma valve implantation in child deserves some attention.Objective This study was to retrospectively evaluate the efficacy and safety of FP-7/FP-8 Ahmed glaucoma valve implantation for refractory glaucoma in children.Methods The clinical data of 30 eyes of 26 children with refractory glaucoma who undergone FP-7/FP-8 Ahmed glaucoma valve implantation in the Center Hospital of Cangzhou from October 2008 to April 2011 were retrospectively analyzed.The age of patients was 4 months to 16.5 years.The patients included ocular hypertension after trabculectomy/goniotomy for cogenital glaucoma,later stage of cogenital glaucoma,aphakic or pseudophakic glaucoma,traumatic glaucoma and Sturge-Weber syndrome.The follow-up ranged from 1 week to 24 months to obverse the changes of intraocular pressure (IOP),postoperative complications and cumulative success rate.Results The mean IOP was significantly different among various time points (F=58.929,P＜0.05).The IOP was (36.93± 10.56) mmHg in preoperation and (13.13± 3.34),(14.13±3.15),(15.93±4.76),(17.96±5.37),(19.74±5.43) mmHg 1 week,1 month,6 months,12 months,24 months following surgery,showing significant reduce after operation.Compared with preoperative IOP,the IOP of 1 week,1 month,6,12,24 months after AGI was significant decreased,with significant differences between them (t =11.641,11.458,10.688,7.988,8.018,all at P ＜ 0.05).The total cumulative success rate after Ahmed glaucoma valve implant was 100％,96.67％,93.21％,85.76％ and 71.46％ 1 week,1 month,6 months,12 months,24 months after surgery.The postoperative complications occurred in 8 eyes,including shallow anterior chamber,drainage tube obstruction,hyphema of anterior chamber and valve exposure,and these were cured by medicine and surgery.No serious complication appeared in all patients after operation.Conclusions FP-7/FP-8 Ahmed glaucoma valve implantation is an effective and safe method for the treatment of refractory glaucoma,and it can be considered as one of the first choices for management of refractory glaucoma in childhood.