Ahmed valve implantation for uncontrolled pediatric uveitic glaucoma

Purpose: We sought to evaluate the safety and efficacy of Ahmed valve implantation for the management of glaucoma associated with chronic uveitis in pediatric patients. Methods: A retrospective chart review was conducted of 6 pediatric patients (7 eyes) who underwent Ahmed valve implantation because of refractory uveitic glaucoma. Intraocular pressure (IOP) reduction, preoperative and postoperative visual acuities, the number of hypotensive medications required, and complications associated with the operation were evaluated. Results: Mean follow-up was 36.8 months (range, 6-60). At the last visit, all 7 eyes had IOPs between 9 and 18 mm Hg (average, 12.1). IOP reduction averaged 69.6% (P = 0.0005, paired t-test). The number of hypotensive agents was reduced from an average of 3 to an average of 0.71 medicines per eye (P = 0.001). The only complication was hemorrhagic choroidal detachment postoperatively in two eyes; both resolved within one month. Conclusions: For children with good immunomodulatory control of their inflammation and appropriate follow-up, Ahmed valve implantation can be an effective and safe procedure for treating pediatric uveitic glaucoma.