The Results of Ahmed Valve Operations

A Comparison Between Superior and Inferior Ahmed Glaucoma Valve Implantation: Surgical Success and Complications

Glaucoma drainage devices are usually placed in the superior quadrants. The superotemporal quadrant is usually the site of choice. However, when the upper fornix is scarred and especially when conjunctiva is two fibrotic to enable adequate coverage of tube with a scleral or other patch graft, some surgeons place the tube in one of inferior quadrants.

Glaucoma drainage devices are usually placed in the superior quadrants. The superotemporal quadrant is usually the site of choice. However, when the upper fornix is scarred and especially when conjunctiva is two fibrotic to enable adequate coverage of tube with a scleral or other patch graft, some surgeons place the tube in one of inferior quadrants.

In the present study we will compare the outcome and complicatons of both the superior and the inferior approach for inserting Ahmed Valve implants.

Inclusion criteria:

1. Patients at the ages of 20-85 on the date of the surgery
2. The indication for the surgery was: uncontrolled glaucoma with maximally tolerated medical therapy who did not or were not expected to respond to other surgical procedures than seton surgery.
3. Visual acuity of, at least, 20/800 before the operation.
4. Regular post operative follow ups, for at least 1 year.
5. Patients after corneal transplantation for whom the indication of valve implantation was uncontrolled glaucoma.

Exclusion Criteria:

1. A previous seton surgery in the operated eye
2. Uveitic glaucoma patients or history of uveitis in the operated or in the fellow eye.
3. Any inflammatory or ocular surface disease that could affect the healing of the conjunctiva after the surgery ( e.g: OCP)
4. Strabismus or complains of diplopia prior to the seton surgery.
5. Past history of retinal detachment surgery with scleral buckle in the operated eye
6. Past history of endophthalmitis in the operated eye.