Implantation Of Ahmed Valve For The Treatment Of Refractory Pediatric Glaucoma (a Report Of Four Cases)

Objective:To evaluate the short-term efficacy of Ahmed valve implantation for the treatment of refractory pediatric glaucoma, and to describe the post-operative complications and their managements.Methods:Ahmed glaucoma valves were implanted in 4 eyes of 4 patients, aged from 6 to 10, with refractory pediatric glaucoma in the inpatients of the 2nd Affiliated Hospital of Zhejiang University from March 2008 to March 2010. The follow-up period was 7 to24 months. The clinical data including visual acuity, intraocular pressure before and after the surgery, as well as post-operative complications were recorded. A through literature review on the treatment of pediatric glaucoma with valves implantation were made.Results:From March 2008 to March 2010, Ahmed valves were implanted in 4 eyes (4 patients) of refractory pediatric glaucoma including one with Sturge-Weber syndrome, one with Coat's disease, and two with primary congenital glaucoma had previous failed filtration surgeries. The surgical procedure was Ahmed valve implantation. The IOP of each patient was decreased dramatically after surgery, and the use of anti-glaucoma medications was reduced. The visual acuity was maintained stable. No major post-operative complications in all patients were observed The blind eye had Coat's disease developed secondary retinal detachment 16 months post-operatively and mild tube-corneal touch was seen in this eye due to hypotony and anterior chamber shallowing.Conclusion:The preliminary results of this case series suggest that implantation of Ahmed valve was effective in the treatment of refractory pediatric glaucoma without major post-operative complications. Further studies are needed to confirm this.