Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus: short-term results

Purpose To evaluate the clinical outcomes of pseudophakic/aphakic eyes with uncontrolled glaucoma that underwent Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus. Methods Medical records of the patients who underwent Ahmed glaucoma valve implantation through the ciliary sulcus, between December 2017 and June 2019, were reviewed retrospectively. Patients' age, gender, glaucoma diagnosis, visual acuity, intraocular pressure levels, and complications were recorded. Results Forty-seven eyes of 43 patients with glaucoma were enrolled. The mean age was 54.5 +/- 19.9 years (range, 7-88 years) at the time of surgery, and the mean postoperative follow-up period was 7.9 +/- 3.4 months (range, 3-16 months). The mean preoperative intraocular pressure level was 35.2 +/- 6.8 mmHg (range, 25-55 mmHg), and it was found as 15.6 +/- 5.4 mmHg (range, 9-33 mmHg) at the last follow-up visit. Decrease in intraocular pressure level was statistically significant (P < 0.001). At the last follow-up visit, success (postoperative IOP >= 6 mmHg and <= 21 mmHg with or without antiglaucomatous medications, without further surgery for IOP control, without loss of light perception and without removal of the implant) was achieved in 41 eyes (87.2%). Hyphema was the most common postoperative complication and developed in 11 eyes (23.4%) and resolved spontaneously in all of them within one month. Conclusion In pseudophakic or aphakic eyes with uncontrolled glaucoma, placement of Ahmed glaucoma valve tube in the ciliary sulcus is a safe and effective procedure. Ciliary sulcus can be considered as a potential space during tube shunt surgery in eyes with high risk of tube-corneal touch or corneal decompensation.