This study aimed to assess the efficacy and safety of Ahmed glaucoma valve (AGV) implantation in eyes with pediatric keratoplasty and glaucoma.
Retrospective, non-comparative, interventional case series.
Twenty-eight eyes of 25 children that underwent AGV following penetrating keratoplasty (PK) in 22 eyes and Descemet’s stripping endothelial keratoplasty (DSEK) in 6 eyes were included.
Children (age ≤16 years) treated with AGV implant following keratoplasty from 2008-2019 with documented 6 months follow-up operated by a single surgeon were included.
The primary outcome measure was AGV survival (intraocular pressure (IOP) between 6 and 21 mmHg with or without topical anti-glaucoma medications (AGM)), and the secondary outcome measure was corneal graft survival.
The Mean age (±standard deviation) at AGV surgery was 4.8 ± 0.7 years. Mean follow-up after AGV was 3.4±0.5 years. Mean IOP (mmHg) decreased significantly from 31.5±2.0 to 21.1±2.3 at 6 months post-surgery (p<0.001). The mean number of AGM reduced significantly (p0.04 with Bonferroni correction). The cumulative survival probability of AGV was 92.9±4.9% at 1 year and 81.3±11.7% at 5 years. The AGV success was comparable between PK and DSEK eyes (p=0.73). The cumulative probability of graft survival was 96.2±3.8% at 1 year and 77.8±9.1% at 5-years. The graft survival was also comparable between PK and DSEK eyes (p=0.18). One eye needed tube trimming; none had tube or implant exposure. The major complication noted was corneal graft infection in eight eyes (28.5%).
In this cohort, the long-term AGV success and graft survival outcomes are satisfactory considering that AGV was performed in complex eyes with keratoplasty.

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