Baerveldt glaucoma implant in the management of refractory childhood glaucomas

Budenz, Donald L.; Gedde, Steven J.; Brandt, James D.; Kira, David; Feuer, William J.; Larson, Eric

doi:10.1016/j.ophtha.2004.05.017

Cited by 84 publications

(82 citation statements)

References 43 publications

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“…Retinal detachment is rarely reported after AVI, but the rates in our study (2.9%) were similar to those reported with other implants. 23,26,54 Retinal detachment following choroidal detachment is reported after severe ocular inflammation, 55 but in our case, there was no sign of severe inflammation. A silent retinal tear or shallow retinal detachment may have been present much earlier in the development of hypotony, masked by choroidal detachment.…”

Section: Discussionmentioning

confidence: 57%

“…The mean number of previous glaucoma surgeries before Ahmed implant was 3 (range, 1-5). The time interval between the successive implantations was 18.8±7.9 months (range, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The mean follow-up time after the second AVI was 26.6±12.7 months (range, 12-47).…”

Section: Resultsmentioning

confidence: 99%

“…[20][21][22] Glaucoma drainage devices are widely used in the treatment of refractory paediatric glaucoma, especially when filtering surgery has failed or is known to have a high risk of failure, such as significant conjunctival scarring. 23,24 The first glaucoma drainage device used in the paediatric population was the Molteno implant (IOP Inc., Costa Mesa, CA, USA), 25 followed by the Baerveldt implant (Pharmacia and Upjohn Inc., Kalamazoo, MI, USA) 23,26,27 and Ahmed valve implant (New World Medical Inc., Rancho Cucamonga, CA, USA). 23 The Ahmed valve implant has a protective sleeve, which is designed to open when the aqueous pressure is higher than 8 mm Hg.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

Yang

Park

2008

Eye

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Purpose To evaluate clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma. Methods A retrospective review was conducted on 34 eyes from 29 patients with refractory glaucoma, who were younger than 18 years of age and who underwent Ahmed valve implantation. The main outcome measures were intraocular pressures (IOPs) and the number of glaucoma medications used. Qualified success was defined as IOP p21 mm Hg regardless of the number of glaucoma medications. Complete success was defined as IOP p21 mm Hg without glaucoma medication.Results Mean age at operation was 5.5 years (range, 0-16). Fifteen eyes (44.1%) had undergone previous glaucoma surgery before Ahmed valve implantation. Mean follow-up time was 29.1 months (range, 3-31). IOP was reduced from a preoperative mean of 37.5 ± 7.3 to 18.4 ± 7.3 mm Hg at 6 months postoperatively (Po0.01). At 12 months after surgery, the success rates were 63.3% (qualified success) and 13.3% (complete success). The cumulative probabilities of qualified success at 6, 12, and 24 months after Ahmed valve implantation were 89.0, 68.6, and 45.7%, respectively. The median time of survival was 19.6 ± 0.9 months. Conclusions Ahmed valve implantation is effective in lowering IOP in refractory paediatric glaucoma, with limited survival after long-term follow-up. Addition of a second Ahmed valve may be effective in the management of failure after primary implantation.

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Section: Discussionmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

Yang

Park

2008

Eye

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“…Studies of glaucoma drainage implants in pediatric patients report success rate ranging from 56% to 95%, depending on patient age, type of glaucoma, variations in the defi nition of success, and length of follow up [6][7][8][9][10] . However, complications have been associated with drainage implants in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Initial Clinical Experience With Ahmed Valve Implantation in Refractory Pediatric Glaucoma

Novak-Lauš

Herman

Prskalo

et al. 2016

acc

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SUMMARY -Th e purpose is to report on the safety and effi cacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of IOP below 23 mm Hg (with or without antiglaucoma medications) and changes in visual acuity. Complications were recorded. After AGV implantation, IOP values ranged from 18 mm Hg to 23 mm Hg (except for one eye with postoperative hypotonia due to suprachoroid hemorrhage, where the postoperative IOP value was 4 mm Hg). Th e number of antiglaucoma medications was reduced, i.e. four patients had two medications, one patient had one medication, and the others did not need antiglaucoma medication on the last follow-up visit. One eye had suprachoroid hemorrhage, one eye had long-term persistent uveitic membrane, and two eyes had tube-cornea touch. In conclusion, AGV implantation appears to be a viable option for the management of refractory pediatric glaucoma and shows success in IOP control. However, there was a relatively high complication rate limiting the overall success rate.

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“…At 1-2 year follow-up, many studies report a success of around 80% [85][86][87][88] and this falls to around 50% in the longer term. 72,[89][90][91][92] When debating which GDD performs best in children-there is no clear superiority of one type of GDD versus another, however the Baerveldt implant may provide slightly better long-term IOP control but the Ahmed implant fewer short term complications. [93][94][95] A prospective study comparing the polypropylene against the silicone Ahmed implant in children, has shown better long-term IOP control with the silicone Ahmed.…”

Section: Gddmentioning

confidence: 99%