Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

• Published in: Korean journal of ophthalmology Vol. 29; no. 2; pp. 109 - 114
• Main Authors: Lee, Naeun, Ma, Kyoung Tak, Bae, Hyoung Won, Hong, Samin, Seong, Gong Je, Hong, Young Jae, Kim, Chan Yun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Ophthalmological Society 01.04.2015; 대한안과학회
• Subjects: Child, Preschool; Female; Follow-Up Studies; Glaucoma - congenital; Glaucoma - physiopathology; Glaucoma - surgery; Glaucoma Drainage Implants; Humans; Infant; Intraocular Pressure - physiology; Male; Mitomycin - adverse effects; Nucleic Acid Synthesis Inhibitors - adverse effects; Original; Reoperation; Retrospective Studies; Time Factors; Trabeculectomy - adverse effects; Trabeculectomy - methods; Treatment Failure; Treatment Outcome; Visual Acuity; 안과학; Surgical outcomes; Trabeculectomy; Congenital glaucoma; Ahmed valve implantation
• ISSN: 1011-8942; 2092-9382; 2092-9382
• DOI: 10.3341/kjo.2015.29.2.109

To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.