Ciliary Sulcus Implantation of Ahmed Glaucoma Valve in Patients with Corneal Decompensation Risk.

OBJECTIVES

The goal of this study was to examine the safety and efficacy of ciliary sulcus implantation of the Ahmed glaucoma valve (AGV; New World Medical, Inc., Rancho Cucamonga, CA, USA) in patients with a risk of corneal decompensation.

METHODS

Patients with a corneal decompensation risk who underwent AGV implantation at a single institution were included in this retrospective study. The patients' preoperative intraocular pressure (IOP), best corrected visual acuity (BCVA), and the number of anti-glaucomatous eye drop medications used was compared with postoperative values. The success criteria were defined as a postoperative IOP of 5 to 21 mmHg and no loss of light perception.

RESULTS

Twenty-three eyes of 23 (16 male, 7 female) patients were included in the study. The mean age of the patients was 64.6±14.6 years and the mean follow-up period was 15.8±8.3 months. The preoperative mean IOP was reduced from 33.6±9.1 mmHg to 16.9±5.1 mmHg at the last follow-up (p=0.000). The mean preoperative number of anti-glaucomatous eye drop medications used was 3.5±1.3. Postoperatively the mean was 1.7±1.4 at the last follow-up (p=0.000). The rate of total success was determined to be 78%. The postoperative mean BCVA did not change significantly. One patient lost light perception. A decrease in corneal clarity was observed in only 1 patient (4.3%). The postoperative complications observed were: bleb encapsulation (43%), hyphema (39%), tube occlusion (13%), choroidal detachment (8.7%), decompression retinopathy (8.7%), and corneal decompensation (4.3%).

CONCLUSION

Ciliary sulcus implantation of an AGV was effective, both in terms of IOP and the decrease in anti-glaucomatous drug use in the short term. This technique may be a good choice in patients with a corneal decompensation risk due to the posterior chamber implantation.