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

Abstract

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.