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. 2023 Nov 8;11(11):2996.
doi: 10.3390/biomedicines11112996.

Long-Term Clinical Outcomes of Ahmed Valve Implantation in Aniridic Glaucoma

Bartłomiej Bolek  1   2 , Edward Wylęgała  1   2 , Dorota Tarnawska  2   3
Affiliations

Long-Term Clinical Outcomes of Ahmed Valve Implantation in Aniridic Glaucoma

Bartłomiej Bolek et al. Biomedicines. .

Abstract

Background: This study assessed the efficacy and safety of Ahmed valve implantation in patients with aniridic glaucoma for three consecutive years.

Methods: Six adult patients (seven eyes) with Ahmed valve (AV) implants for aniridic glaucoma were enrolled in the study. The primary outcome measures were intraocular pressure reduction, glaucoma medication use, success rates, and visual acuity after AV implantation. A 30% reduction in IOP from baseline without the need for re-intervention was considered an effective treatment. The cessation of antiglaucoma medications was defined as complete success. Intraoperative and postoperative complications were included as secondary outcome measures. Measurements were performed preoperatively, at the first week, and 1, 3, 6, 12, 18, 24, 30, and 36 months postoperatively.

Results: A total of seven eyes (6 patients) were evaluated 36 months after AV implantation. The mean ± SD values of IOP preoperatively at 1 day, 1 week, and 1, 3, 6, 12, 18, 24, 30, and 36 months postoperatively were 30.4 ± 4.0 mmHg, 14.6 ± 4.6 mmHg, 16.1 ± 4.6 mmHg, 20.7 ± 7.0 mmHg, 14.5 ± 2.7 mmHg, 16.5 ± 5.9 mmHg, 16.2 ± 4.0 mmHg, 16.3 ± 4.3 mmHg, 17.2 ± 10.1 mmHg, 17.6 ± 6.9 mmHg, and 18.2 ± 5.5 mmHg, respectively. At the last follow up, the mean IOP was reduced by 40.2%. The qualified success rate was 85.7%. One patient (one eye) at the last follow-up visit did not require antiglaucoma medications, resulting in a complete success rate of 14.3%. Intra- and postoperative mild or moderate subconjunctival bleeding was observed in all the patients. No other major/minor intraoperative or postoperative complications were noted.

Conclusions: In long-term follow up, the AV implantation procedure is well-tolerated and relatively safe for reducing IOP in adult aniridia patients with glaucoma. These results should be validated through studies involving a larger patient cohort.

Keywords: Ahmed valve; aniridia; glaucoma; glaucoma drainage device; intraocular pressure.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intraocular pressure after AV implantation—36-month follow up. AV—Ahmed valve; IOP—intraocular pressure.
Figure 2
Figure 2
Kaplan–Meier survival curve of qualified success after AV implantation—36-month follow up.
Figure 3
Figure 3
Kaplan–Meier survival curve of complete success after AV implantation—36-month follow up.
Figure 4
Figure 4
Scatter plot as preoperative IOP (x-axis) versus 3-year postoperative IOP (y-axis). Yellow slope diagonal line represents 30% IOP reduction. AV—Ahmed valve, IOP—intraocular pressure.
Figure 5
Figure 5
Number of antiglaucoma medications preoperative and postoperative at last follow up. AV—Ahmed valve.
Figure 6
Figure 6
Left eye of the patient with aniridia and aphakia after Ahmed valve implantation. The valve tube in the anterior chamber is visible. Grade 2 aniridia-associated keratopathy can be noted.
See this image and copyright information in PMC

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