AHMED VALVE IMPLANT FOR UNCONTROLLED UVEITIC GLAUCOMA

To evaluate the efficacy of the Ahmed valve implant in patients with u ncontrolled uveitic glaucoma, the medical records of all patients with uncontrolled uveitic glaucoma who underwent Ahmed valve implant surge ry between October 1993 and March 1996 were reviewed. Surgery was cons idered a success if intraocular pressure (IOP) was less than 22 mmHg a nd greater than 4 mmHg (with or without antiglaucoma medications) at t he last postoperative visit, It was not a success when further glaucom a surgery had been performed, or chronic hypotony, phthisis, or loss o f light perception occurred. Fourteen patients (14 eyes) with a mean a ge 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 on e 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 pres sure 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) preoperativel y 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). Th e 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 pa tients with uncontrolled uveitic glaucoma who have had multiple previo us ocular surgeries.