Long-term Clinical Outcomes of Ahmed and Baerveldt Drainage Device Surgery for Pediatric Glaucoma Following Cataract Surgery

Precis: In this retrospective case series, both Baerveldt and Ahmed glaucoma drainage devices resulted in good long-term outcomes in eyes with pediatric glaucoma following cataract surgery (GFCS). Background: The aim of this study was to describe the long-term safety and efficacy of primary glaucoma drainage device surgery in patients with pediatric GFCS. Methods: We retrospectively identified 28 eyes of 28 patients with GFCS that underwent tube shunt surgery with the Ahmed Glaucoma Valve or Baerveldt Glaucoma Implant. The primary outcome measure was a surgical failure, defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on 2 consecutive follow-up visits after 3 months, IOP <5 mm Hg on 2 consecutive follow-up visits after 3 months, and reoperation for glaucoma. Results: The mean duration between cataract removal and the diagnosis of glaucoma was 3.6 +/- 1.5 years. Kaplan-Meier survival curves indicated a mean time to failure of 41.9 +/- 2.1 months after drainage device surgery. The cumulative probability of failure at 1, 2, 3, and 4 years was 3.6%, 19%, 28%, and 28%. IOP was significantly decreased from 29.3 +/- 4.1 mm Hg preoperatively to 17.6 +/- 1.6 mm Hg at the final follow-up visit (P<0.001). The number of glaucoma medications at baseline was 3.1 +/- 0.6, which decreased to 2.1 +/- 0.7 at the final visit (P=0.001). Conclusions: Glaucoma drainage device surgery results in good long-term outcomes in patients with GFCS.