Efficacy of Ahmed Glaucoma Valve and Trabeculectomy With Mitomycin-C in Pediatric Glaucoma

Abstract

Objective: To compare the efficacy between Ahmed glaucoma valve surgery and Trabeculectomy with Mitomycin-c in pediatric glaucoma. Study design and setting: Quasi-experimental study was conducted at Pediatric Ophthalmology Department, ISRA Post graduate Institute of Ophthalmology/ Al-Ibrahim Eye Hospital, Karachi. Duration of study was February to August 2016. Methodology: Samples were divided into two groups. Group A Trabeculectomy with Mitomycin-C and Group B with Ahmed Glaucoma valve surgery. Inclusion criteria were children (above 2 years and less than 15 years of age) visiting Pediatric Ophthalmology OPD irrespective of gender, glaucoma diagnosed with the duration of symptoms > 4 weeks. Exclusion criteria were patient with repeat surgery for glaucoma, combined ocular surgery i.e penetrating keratoplasty or cataract, Preoperative keratitis, uveitis or conjunctivitis, as determined by slit-lamp examination. Paired sample t-test was applied to compare the pre and post IOP examination findings. P-value = 0.05 considered as statistically significant. Results: A total of 110 patients were recruited in this study in which 97 patients were analyzed. Mean age of Group A was 6.73±2.7 and mean age of Group B was 7.05±2.3. Mean pre-operative IOP in “Group A” was found to be 31.59±5.4 and post-operative IOP was reduced to 17.95±4.8 with statistically significant P-value <0.0001. In “Group B” Mean preoperative IOP was 30.60±5.3 and post-operative IOP was 18.43±3.8 with statistically significant P-value <0.0001. Conclusion: A significant difference found between efficacy of Ahmed glaucoma valve surgery and Trabeculectomy with Mitomycin-C in pediatric glaucoma after 4th week of surgery.

Comparison of tube shunt implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis

“…A total of 3795 eyes were included in this study, which included 670 eyes in the Ahmed group, 561 eyes in the Baerveldt group, 473 eyes in the Ex-PRESS group, 199 eyes in the XEN group and 1892 eyes in the trabeculectomy group. Sixteen of the 49 studies had an RCT design,25–27 37 39 48 49 51–53 55 56 59 62 64 66 and the others had a retrospective or prospective comparative design 19–24 28–36 38 40–47 50 54 57 58 60 61 63 65 67. Overall, the included RCTs demonstrated a low risk of bias for the majority of domains evaluated (online supplemental figure S1).…”

“…In all, 3552 articles were initially identified. After applying the exclusion criteria, 49 articles were included in this meta-analysis, as shown in figure 1 19–67. A total of 3795 eyes were included in this study, which included 670 eyes in the Ahmed group, 561 eyes in the Baerveldt group, 473 eyes in the Ex-PRESS group, 199 eyes in the XEN group and 1892 eyes in the trabeculectomy group.…”