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The Ahmed Glaucoma Valve: Medium Range Results
Hille K., Rossi M., Ruprecht K. W.,
Universitätskliniken des Saarlandes, Augenklinik und Poliklinik (Homburg/Saar)
Purpose: Common drainage systems of Molteno type usually lead to extreme hypotension of the eye in the first postoperative period. The Ahmed Glaucoma Valve has a valve system to avoid this problem.
Method: In a series of 26 eyes of 22 patient an Ahmed Valve was implanted. The indication were end stage glaucoma in PCOWG (7), in aniridia (4), following injuries (4), in children (4), in uveitis (2) and varia (5). The medium follow up is 12 month (1-44), the average of the age on surgery 41 years (5-79). The präoperative IOP was 35.5 mmHg (22-66), 17 were pseudo phake, 9 aphake.
Results: Mostly the eye pressure was between 4 and 10 mmHg in the first three weeks, only in 4 there was a hypotonia of less than 4 mmHg. 2 eyes developed a temporary detachment of the chorioidea. At the last visit the intraocular pressure was regulated in 22 eyes (85%) but not regulated in 3. In one eye the implant had to be removed due to an infection. No severe other complications as expulsive bleeding etc. occurred.
Conclusions: The implantation of an Ahmed Glaucoma Valve in pseudo- or aphakic eyes is a save procedure with a success rate comparable to other glaucoma implants. In the first postoperative period the Ahmed Glaucoma Valve reduces the intraocular pressure with a very low risk of excessive hypotension. The Ahmed Glaucoma Valve can be used as an alternative to the classical drainage systems.