To evaluate the efficacy of the Ahmed valve implant in patients with uncontrolled uveitic glaucoma, the medical records of all patients with uncontrolled uveitic glaucoma who underwent Ahmed valve implant surgery between October 1993 and March 1996 were reviewed. Surgery was considered a success if intraocular pressure (IOP) was less than 22 mmHg and greater than 4 mmHg (with or without antiglaucoma medications) at the last postoperative visit. It was not a success when further glaucoma surgery had been performed, or chronic hypotony, phthisis, or loss of light perception occurred. Fourteen patients (14 eyes) with a mean age of 45.7 years were included. Most of them were high-risk patients, many of whom had already had cataract surgery (71.4%) and undergone one to three previous glaucoma surgeries (57.1%). Follow-up for eyes in which IOP was controlled ranged from 11 to 40 months (mean 22.6 months). Success was achieved in eight of 14 eyes (57.14%). Intraocular pressure was reduced from a mean of 32.64 +/- 7.79 mmHg (range 23-46 mmHg) with 2.78 +/- 0.57 antiglaucoma medications (range 2-4) preoperatively to 17.57 +/- 10.93 mmHg (range 0-38 mmHg) (p < 0.0001) with 0.71 +/- 0.99 antiglaucoma medications (range 0-3) postoperatively (p < 0.0001). The most common complications were encapsulated bleb in six eyes (42.8%), transient hypotony in six eyes (42.8%), and hyphema in three (21.4%). Ahmed valve implant appeared to be a safe alternative in high-risk patients with uncontrolled uveitic glaucoma who have had multiple previous ocular surgeries.

Purpose:To evaluate the results and extrusion rates of the Ahmed glaucoma valve (AGV) implantation through a needle-generated scleral tunnel, without a tube-covering patch, in children.Materials and Methods:A retrospective review of the charts of 106 Mexican children implanted with 128 AGVs operated between 1994 and 2002, with the needle track technique, at our institution, with at least six months follow up was done. Main outcome measures were intraocular pressure (IOP) control, tube extrusions or exposure and other complications.Results:Kaplan-Meier analysis demonstrated a 96.9% survival rate at six months, 82.4% at one year, 78.7% at two years, 70% at three years and 41.6% at four years. Total success at the last follow-up (IOP between 6 and 21 mm Hg without medications) was achieved in 30 eyes (23.5%), 58 eyes (45.3%) had qualified success (only topical hypotensive drugs) and 40 eyes (31.3%) were failures. The mean pre- and post-operative IOP at the last follow up was 28.4 mmHg (SD 9.3) and 14.5 mmHg (SD 6.3), respectively. No tube extrusions or exposures were observed. Tube-related complications included five retractions, a lens touch and a transitory endothelial touch. The risk of failure increased if the eye had any complication or previous glaucoma surgeries.Conclusion:Medium-term IOP control in Mexican children with glaucoma can be achieved with AGV implantation using a needle-generated tunnel, without constructing a scleral flap or using a patch to cover the tube. There were no tube extrusions, nor any tube exposures with this technique.

Patterned laser trabeculoplasty provides rapid, precise, and minimally traumatic (sub-visible) computer-guided treatment with exact abutment of the patterns, exhibiting a 24% reduction in intraocular pressure during 6 months of follow-up (P < .01).