Efficacy of the Ahmed glaucoma valve implant in eyes with refractory glaucoma.

BACKGROUND: Implantation of glaucoma drainage devices is currently considered as a good alternative to the traditional treatment of refractory glaucoma.

AIM: To evaluate the efficacy and safety of the Ahmed glaucoma valve implant in eyes with refractory glaucoma.

METHODS: This retrospective study included 27 eyes from 27 patients with refractory glaucoma treated with the Ahmed glaucoma valve implant between February 1995 and January 2000. We reviewed the final intraocular pressure and incidence of complications in all patients.

RESULTS: The most common aetiology of refractory glaucoma was open-angle glaucoma (48.1%) followed by neovascular glaucoma (29.6%). After a mean follow-up of 35.74 months (range 9-52 months), the mean intraocular pressure decreased from 35.66 mm Hg before surgery to 14 mm Hg on the last follow-up visit after surgery. Thus, the procedure was successful in 69.23% of cases. Nine patients (33.33%) achieved reduced intraocular pressure without additional antiglaucomatous medication. Transient postoperative hypotony of < 5 mm Hg occurred in 14.8 % of patients. This was, with transient hyphaema, the most common postoperative complication.

CONCLUSION: The Ahmed glaucoma valve implant seems to be effective and safe for the management of refractory glaucoma. However, it is less effective in case of neovascular glaucoma.