Outcome of Ahmed glaucoma valve implant in congenital fibrovascular pupillary membrane with secondary glaucoma.

Abstract

Background: Congenital fibrovascular pupillary membranes in secondary glaucoma (CFPMSG) is kind of refractory childhood glaucoma. The aim of the study is to evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implants in CFPMSG.

Methods: Twelve patients with CFPMSG who underwent anterior chamber reconstruction (ASR) with a stable anterior chamber but uncontrolled intraocular pressure (IOP) underwent AGV implantation. Patients with a follow-up period of > 12 months were enrolled. Demographic data were collected. All patients underwent comprehensive ophthalmic examinations before and after surgeries, including IOP measurement, A- and B-scan ultrasonography, and ultrasound biomicroscopy (UBM), etc. Success was defined as postoperative intraocular pressure (IOP) ≤ 21 mmHg with (qualified success) or without (complete success) the use of glaucoma drugs.

Results: The median age of enrolled patients was 15.1 ± 12.5 months old (range 4.5-46) and 58.3% of them were female. At last follow-up (32.0 ± 16.0 months), the average IOP was declined (postoperative: 18.7 ± 4.5 mmHg vs. preoperative: 29.0 ± 4.0 mmHg, p < 0.001). The number of glaucoma drugs decreased from 3 (range 2-3) to 1.5 (range 0-3) (P < 0.001), while the anterior chamber depth (ACD) remained stable (3.21 ± 0.70 mm and 3.40 ± 0.82 mm, respectively) (p = 0.57) after AGV implantation. The complete success rate was 25% (3/12) and the qualified success rate was 58.3% (7/12). The total success rate was 83.8%. No severe complications were noted.

Conclusions: This study demonstrated that AGV implants could be safe and effective for CFPMSG with uncontrolled IOP. AGV implantation is a feasible option for the treatment of CFPMSG.