The Ahmed Glaucoma Valve in Refractory Glaucoma Experiences in Southwest Ethiopia

Abstract

BACKGROUND: The management of refractory glaucoma is a challenging task for any glaucomasurgeon. This study is aimed to evaluate the efficacy of Ahmed Glaucoma Valve implantation inrefractory glaucomas in South-West Ethiopia.METHODS: A retrospective review was conducted on the charts of consecutive patients treated withAhmed glaucoma valve implantation at Jimma University Specialized Hospital between August 2012 andAugust 2014. Success was defined as Intraocular Pressure (IOP) less than 22 mm Hg and greater than5mm Hg at 6 months, with at least 30% reduction from baseline, without medical therapy (completesuccess) or either with or without medication (qualified successes)..RESULTS: A total of 12 eyes of 11 patients were included. The mean age of patients was 40.7 (SD= 19.0)years; 63.6% of them were males. The main types of glaucoma were pseudoexfoliative (3 eyes), uveitic (2eyes), chronic angle closure (2 eyes) and Juvenile Open Angle (JOAG) (2 eyes). The mean IOP wasreduced from preoperative level (32.75±7.14 mmHg) to (15.75 ±4.35 mmHg) at six postoperative months,(P<0.001); 66.7% eyes had complete successes while 83.3% had qualified success. Intra- operativecomplications were encountered in 2(16.7%) eyes, while 5/12 (41.7%) eyes had post-operativecomplications-hypotony (one with choroidal effusion) and progression of cataract in 2 eyes each.Hypertensive phase was diagnosed in 2(16.7%) eyes.CONCLUSION: The Ahmed glaucoma valve implant appears to be effective and relatively safe fortreating complicated glaucomas with success rate comparable with those reported from other studies.