Ologen-Augmentation of Ahmed Valves in Pediatric Glaucomas: 2- to 6-Year Follow-up.

PURPOSE

Determine 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (OAGDs) in children with glaucoma.

DESIGN

Retrospective interventional case series.

SUBJECTS

Children (<18 years of age) with glaucoma requiring surgery for intraocular pressure (IOP) control with at least 2 years of postoperative follow-up.

METHODS

Placement of OAGD between 2018 and 2022.

MAIN OUTCOME MEASURES

Change in IOP, number of glaucoma medications and best-corrected visual acuity from preoperative to final follow-up, and success of surgery (complete defined as IOP 5 to 20 mmHg without additional medications, visually devastating complication or additional IOP-lowering surgeries, qualified success defined as above except IOP control was maintained ± glaucoma medications).

RESULTS

Forty eyes of 28 patients underwent OAGD at median age of 2.6 years (interquartile range [IQR], 0.6-7.8). Primary congenital glaucoma was the most common diagnosis (12 eyes of 9 patients), followed by glaucoma secondary to nonacquired ocular anomaly (11 eyes of 6 patients). Twenty-two eyes of 16 patients had prior glaucoma surgery (median 2, [interquatile range (IQR), 1-2]). Preoperative IOP was a median of 27 mmHg (IQR, 24-35) on a median of 3 (IQR, 2-3) glaucoma medications. At final follow-up (median 3.6 years [IQR, 2.9-4.3]), IOP (median, 15 mmHg [IQR, 13-17]) and glaucoma medications (median, 0 [IQR, 0-0]) were significantly decrease (P < 0.0001). Complete success at final follow-up was 55% (22 of 40 eyes) with 3- and 5-year survival rates of 75% (95% confidence interval [CI], 59-86) and 57% (95% CI, 35-74). Qualified success rate was 75% (30 of 40 eyes) with 3- and 5-year survival rates of 87% (95% CI, 71-95) and 67% (95% CI, 42-83), respectively.

CONCLUSIONS

Although OAGD decreased IOP and the number of glaucoma medications, the high survival rates seen over the first 3 years decreased by 5 years. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.