Ologen-augmentation of Ahmed valves in pediatric glaucomas: 2-6 Year Follow-up.

Abstract

Purpose: Determine 2 to 6 year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGD) in children with glaucoma.

Design: Retrospective interventional case series SUBJECTS: Children (less than years of age) with glaucoma requiring surgery for IOP (intraocular pressure) control with at least 2 years of post-operative follow-up.

Methods: Placement of OAGD between 2018 and 2022.

Main outcome measures: Change in IOP, number of glaucoma medications and best corrected visual acuity (BCVA) from preoperative to final follow-up, Success of surgery (complete defined as IOP 5-20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications.

Results: Forty eyes of 28 patients underwent OAGD at median age of 2.6 years [IQR 0.6, 7.8]. Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients) followed by glaucoma secondary to non-acquired ocular anomaly (11 eyes of 6 patients).Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [IQR 1,2]). Preoperative IOP was median 27 mmHg [IQR 24, 35] on median 3 [IQR 2, 3] glaucoma medications. At final follow-up (median 3.6 years [IQR 2.9, 4.3]), IOP (median 15 mmHg [IQR 13, 17]) and glaucoma medications (median 0 [IQR 0,0]) were significantly decrease (p<0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% with 95% CI[59, 86] and 57% with 95% CI[35,74]. Qualified success rate was 75% (30 of 40 eyes) with 3- and 5- year survival rates of 87% with 95% CI[71, 95] and 67% with 95% CI[42, 83].

Conclusions: While OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years.