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Meta-Analysis
. 2023 Jul-Aug;68(4):578-590.
doi: 10.1016/j.survophthal.2023.01.010. Epub 2023 Feb 3.

Efficacy of Ahmed and Baerveldt glaucoma drainage device implantation in the pediatric population: A systematic review and meta-analysis

Jeannette Y Stallworth  1 , Kieran S O'Brien  2 , Ying Han  1 , Julius T Oatts  3
Affiliations
Meta-Analysis

Efficacy of Ahmed and Baerveldt glaucoma drainage device implantation in the pediatric population: A systematic review and meta-analysis

Jeannette Y Stallworth et al. Surv Ophthalmol. 2023 Jul-Aug.

Abstract

Glaucoma drainage devices (GDD) are increasingly utilized in the management of childhood glaucoma. This systematic review and meta-analysis assesses the efficacy of first-time Ahmed or Baerveldt implantation in children. PubMed, Embase, and Cochrane Library were searched for relevant English-language, peer-reviewed literature. Postoperative outcomes were pooled using random effects regression models with restricted maximum likelihood estimation. Thirty-two studies (1,221 eyes, 885 children) were included. Mean ± standard deviation preoperative IOP was 31.8 ± 3.4 mm Hg. Pooled mean IOP at 12 and 24 months postoperatively were 16.5 mm Hg (95% CI, 15.5-17.6) and 17.6 mm Hg (95% CI, 16.4-18.7), respectively. Pooled proportions of success were 0.87 (95% CI, 0.83-0.91) at 12 months, 0.77 (95% CI, 0.71-0.83) at 24 months, 0.54 (95% CI, 0.44-0.65) at 48 months, 0.60 (95% CI, 0.48-0.71) at 60 months, and 0.37 (95% CI, 0.32-0.42) at 120 months. There were no differences in proportion of success at 12 and 24 months among eyes that received Ahmed and Baerveldt tube shunts, nor between eyes with primary glaucoma, glaucoma following cataract surgery, or other secondary glaucoma. Our findings show that Ahmed and Baerveldt shunts substantially reduced IOP for at least 24 months in childhood glaucoma, with similar findings among device types and glaucoma etiologies.

Keywords: Ahmed glaucoma valve; Baerveldt glaucoma implant; Childhood glaucoma; Glaucoma drainage device; Systematic review and meta-analysis.

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Conflict of interest statement

Conflicts of Interest: The authors report no commercial or proprietary interest in any product or concept discussed in this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram delineating search, screening, and eligibility assessment process.
Figure 2.
Figure 2.. Forest plots of mean intraocular pressure (A) 12 months and (B) 24 months after implantation of Ahmed and Baerveldt glaucoma drainage devices.
Results of random effects regression models for each subgroup and test for subgroup differences are shown, except where a subgroup contained less than two studies. Abbreviation: CI (confidence interval); MMC (mitomycin-C); RE (random effects)
Figure 2.
Figure 2.. Forest plots of mean intraocular pressure (A) 12 months and (B) 24 months after implantation of Ahmed and Baerveldt glaucoma drainage devices.
Results of random effects regression models for each subgroup and test for subgroup differences are shown, except where a subgroup contained less than two studies. Abbreviation: CI (confidence interval); MMC (mitomycin-C); RE (random effects)
Figure 3.
Figure 3.. Forest plots of proportion of success (A) 12 months and (B) 24 months after implantation of Ahmed and Baerveldt glaucoma drainage devices.
Results of random effects regression models for each subgroup and test for subgroup differences are shown. Abbreviation: CI (confidence interval); MMC (mitomycin-C); PCG (primary congenital glaucoma); RE (random effects)
Figure 3.
Figure 3.. Forest plots of proportion of success (A) 12 months and (B) 24 months after implantation of Ahmed and Baerveldt glaucoma drainage devices.
Results of random effects regression models for each subgroup and test for subgroup differences are shown. Abbreviation: CI (confidence interval); MMC (mitomycin-C); PCG (primary congenital glaucoma); RE (random effects)
See this image and copyright information in PMC

References

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