Efficacy of Ahmed and Baerveldt glaucoma drainage device implantation in the pediatric population: A systematic review and meta-analysis

• Published in: Survey of ophthalmology Vol. 68; no. 4; pp. 578 - 590
• Main Authors: Stallworth, Jeannette Y., O'Brien, Kieran S., Han, Ying, Oatts, Julius T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2023
• Subjects: Ahmed glaucoma valve; Baerveldt glaucoma implant; Child; Childhood glaucoma; Follow-Up Studies; Glaucoma - surgery; Glaucoma drainage device; Glaucoma Drainage Implants; Humans; Intraocular Pressure; Postoperative Complications - surgery; Prosthesis Implantation; Retrospective Studies; Systematic review and meta-analysis; Trabeculectomy; Treatment Outcome; Childhood glaucoma; Glaucoma drainage device; Baerveldt glaucoma implant; Ahmed glaucoma valve; Systematic review and meta-analysis
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/j.survophthal.2023.01.010

Glaucoma drainage devices (GDD) are increasingly utilized in the management of childhood glaucoma. This systematic review and meta-analysis assesses the efficacy of first-time Ahmed or Baerveldt implantation in children. PubMed, Embase, and Cochrane Library were searched for relevant English-language, peer-reviewed literature. Postoperative outcomes were pooled using random effects regression models with restricted maximum likelihood estimation. Thirty-two studies (1,221 eyes, 885 children) were included. Mean ± standard deviation preoperative IOP was 31.8 ± 3.4 mm Hg. Pooled mean IOP at 12 and 24 months postoperatively were 16.5 mm Hg (95% CI, 15.5–17.6) and 17.6 mm Hg (95% CI, 16.4–18.7), respectively. Pooled proportions of success were 0.87 (95% CI, 0.83–0.91) at 12 months, 0.77 (95% CI, 0.71–0.83) at 24 months, 0.54 (95% CI, 0.44–0.65) at 48 months, 0.60 (95% CI, 0.48–0.71) at 60 months, and 0.37 (95% CI, 0.32–0.42) at 120 months. There were no differences in proportion of success at 12 and 24 months among eyes that received Ahmed and Baerveldt tube shunts, nor between eyes with primary glaucoma, glaucoma following cataract surgery, or other secondary glaucoma. Our findings show that Ahmed and Baerveldt shunts substantially reduced IOP for at least 24 months in childhood glaucoma, with similar findings among device types and glaucoma etiologies.