Long-term outcomes of Ahmed tube implantation in pediatric glaucoma after multiple surgeries.

PURPOSE: To report success of Ahmed glaucoma valve (AGV) implantation in eyes with pediatric glaucoma and subconjunctival scarring from previous surgeries.

METHODS: A retrospective review of pediatric glaucoma patients who underwent AGV implantation after ≥ 2 previous surgeries with conjunctival scarring. Preoperative and postoperative parameters were recorded to study success, defined as intraocular pressure (IOP) < 22 mmHg with or without medications and without serious complications.

RESULTS: Eleven eyes of 10 patients were included, and the mean age was 12.7 years. Diagnoses included primary childhood glaucoma, aphakic glaucoma, and anterior segment anomalies. Mean number of prior ocular surgeries was 3.3 (± 1.3). Final mean IOP was 17.5 (± 4.3) mmHg, significantly different from the preoperative mean of 24.8 (± 6.8) mmHg, p = 0.01. Mean number of anti-glaucoma medications also decreased significantly from 2.8 (± 1.5) to 1.4 (± 1.5), p = 0.02. The success rate was 82% at a mean follow-up of 51.6 (± 10.8) months. Complications were minor and transient.

CONCLUSION: Subconjunctival scarring did not increase the risk of failure of tube shunt surgery.