Second valve implantation more successful than first in primary congenital glaucoma cases

Arch Ophthalmol. 2009;127(11):1436-1441.

The implantation of a second Ahmed glaucoma valve had more successful outcomes than the first implantation in children with primary congenital glaucoma, a study found.

"Thirty-three percent of [Ahmed glaucoma valve] implantations in children with primary congenital glaucoma were successful after 5 years of follow-up. With the implantation of a second [Ahmed glaucoma valve], the 5-year success rate increased to 69%," the study authors said.

Hispanic ethnicity (P = .02) and female patients (P = .005) were linked with increased risk of failure.

The study looked at medical records of 30 eyes of 19 children who had primary congenital glaucoma, a mean age of 1.8 years and a mean preoperative IOP of 28.4 mm Hg. All patients underwent Ahmed glaucoma valve (New World Medical) implantation and a minimum of 6 months follow-up.

The primary outcome measure was the cumulative probability of success of IOP greater than 5 mm Hg and less than 23 mm Hg, at least a 15% reduction of preop IOP, and no serious complications, additional surgery or light perception loss.

The study found that at 1 year, the cumulative probability of success was 63%, but at 5 years, it was 33%. After an additional Ahmed glaucoma valve implantation, at 1 and 2 years, cumulative probability of success was 86%, and at 5 years, it was 69%.