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Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma.

Papadaki TG, Zacharopoulos IP, Pasquale LR, Christen WB, Netland PA, Foster CS

Massachusetts Eye Research and Surgery Institute, Ocular Immunology and Uveitis Foundation, Harvard Medical School Boston, Massachusetts, USA. theklapap@med.uoc.gr

PURPOSE: To present long-term outcomes of Ahmed glaucoma valve implantation for uveitic glaucoma. DESIGN: Interventional case series. METHODS: Retrospective chart review of 60 patients (60 eyes) with uveitic glaucoma who underwent Ahmed valve implantation over a four-year period at a tertiary uveitis referral center. Success definition 1 included patients with an intraocular pressure (IOP) between 5 and 21 mm Hg, reduced by 25% from that before implantation. Success definition 2 (qualified success) excluded those patients in whom serious complications occurred. RESULTS: Mean follow-up time was 30 months (range, six to 87 months; four-year results relate to a cohort of 15 patients). Success rates were 77% and 50% and qualified success rates were 57% and 39% at one and four years, respectively. At four years, 74% of the patients required glaucoma medication to maintain IOP control. The overall complication rate was 12%/person-years. The rate of visual acuity loss was 4%/person-years; that was most commonly attributed to corneal complications that were more likely to occur in patients with preoperative corneal disease (P = .01, Fisher exact test). CONCLUSIONS: Ahmed glaucoma valve implantation is a safe yet moderately successful procedure for uveitic glaucoma. Long-term success rates are enhanced with the use of glaucoma medications, and corneal complications are the most common of all potential serious complications.

Published 2 July 2007 in Am J Ophthalmol, 144(1): 62-69.
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