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Long-term Clinical Outcomes of Ahmed and Baerveldt Drainage Device Surgery for Pediatric Glaucoma Following Cataract Surgery

Esfandiari, Hamed MD*,†; Kurup, Sudhi P. MD*,†; Torkian, Pooya MD; Mets, Marilyn B. MD*,†; Rahmani, Bahram MD*,†; Tanna, Angelo P. MD*,†

doi: 10.1097/IJG.0000000000001335
Original Studies
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Precis: In this retrospective case series, both Baerveldt and Ahmed glaucoma drainage devices resulted in good long-term outcomes in eyes with pediatric glaucoma following cataract surgery (GFCS).

Background: The aim of this study was to describe the long-term safety and efficacy of primary glaucoma drainage device surgery in patients with pediatric GFCS.

Methods: We retrospectively identified 28 eyes of 28 patients with GFCS that underwent tube shunt surgery with the Ahmed Glaucoma Valve or Baerveldt Glaucoma Implant. The primary outcome measure was a surgical failure, defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on 2 consecutive follow-up visits after 3 months, IOP <5 mm Hg on 2 consecutive follow-up visits after 3 months, and reoperation for glaucoma.

Results: The mean duration between cataract removal and the diagnosis of glaucoma was 3.6±1.5 years. Kaplan-Meier survival curves indicated a mean time to failure of 41.9±2.1 months after drainage device surgery. The cumulative probability of failure at 1, 2, 3, and 4 years was 3.6%, 19%, 28%, and 28%. IOP was significantly decreased from 29.3±4.1 mm Hg preoperatively to 17.6±1.6 mm Hg at the final follow-up visit (P<0.001). The number of glaucoma medications at baseline was 3.1±0.6, which decreased to 2.1±0.7 at the final visit (P=0.001).

Conclusions: Glaucoma drainage device surgery results in good long-term outcomes in patients with GFCS.

*Department of Ophthalmology, Northwestern University Feinberg School of Medicine

Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Disclosure: The authors declare no conflict of interest.

Reprints: Angelo P. Tanna, MD, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 440, Chicago, IL 60611 (e-mail: atanna@northwestern.edu).

Received April 23, 2019

Accepted July 7, 2019

Online date: July 30, 2019

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