Ahmed glaucoma valve implantation with and without Ologen adjuvant in pediatric glaucoma.

Abstract

PURPOSE:

To compare outcomes of Ologen augmentation of Ahmed glaucoma valve implantation (AVG) and AGV implantation alone in children operated on for uncontrolled glaucoma.

METHODS:

A prospective study was conducted on 33 eyes (18 right eyes) of 33 children (20 males) operated on following failed initial glaucoma surgeries. Eyes were randomized to the AGV or the AGV-Ologen group. The primary outcome was reduction in IOP on 2 years' follow-up in each group. Success was defined as final intraocular pressure (IOP) of 6-20 mm Hg without vision-threatening complications, additional glaucoma operations, or other signs of glaucoma progression.

RESULTS:

Mean patient age (range; median) in the AGV-Ologen and AGV groups was 6.5 ± 2.1 years (2.5-10; 6.5) and 6.5 ± 1.9 years (3-9.5; 7), respectively (P = 0.897). Mean follow-up was 42.1 ± 13.7 months (25-64, 41) and 43.3 ± 11.4 (27-62, 42), respectively (P = 0.788). The most common glaucoma diagnosis in each group was primary congenital glaucoma (82.4% and 81.2% resp.). There was significant postoperative reduction in IOP and the number of IOP-lowering medications at 24 months' follow-up (P < 0.0001 and P = 0.002 for AGV-Ologen and AGV, resp.). The AGV-Ologen group demonstrated statistically significantly lower IOP values at all time points than the AGV group. At 24 months, the probability of total success was 77% in AGV-Ologen and 63% in AGV (P = 0.46).

CONCLUSIONS:

In our study cohort, AGV implantation was an effective treatment for operated uncontrolled childhood glaucoma for at least 2 years, with Ologen augmentation providing a clear advantage in terms of IOP control, without compromising safety.

• Authors: Ahmed S Elwehidy, Nader H L Bayoumi, Sherein M Hagras, Shereen Elshaer
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 26 Issue 5 Pg. 238.e1-238.e6 (10 2022) ISSN: 1528-3933 [Electronic] United States
• PMID: 36100118 (Publication Type: Randomized Controlled Trial, Journal Article)
• Copyright: Copyright © 2022 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Chemical References

• collagen-glycosaminoglycan copolymer

Topics

• Male
• Child
• Humans
• Glaucoma Drainage Implants
• Prospective Studies
• Visual Acuity
• Follow-Up Studies
• Glaucoma (surgery, drug therapy)
• Intraocular Pressure
• Hydrophthalmos (surgery)
• Prosthesis Implantation
• Treatment Outcome
• Retrospective Studies