Ahmed Glaucoma Valve Extrusion In A 70 Years Old Woman With No History Of Trauma

To present a case featuring exposure of the Ahmed Glaucoma Valve plate and tube in a 76-year-old female diagnosed with neovascular glaucoma and initial ptosis in her right eye, with no reported history of trauma. The patient underwent surgical intervention, encompassing removal of the valve and tube, followed by conjunctival tissue coverage. One month post-surgery, the patient reported absence of pain, and stable ocular pressure was observed.

Our patient presented to the emergency department of Hospital de Terrassa, located in Barcelona, in January 2023.

A 76-year-old woman, who arrived from Morocco, presented with complete exposure of the Ahmed Glaucoma Valve plate and total extrusion of the valve tube in the right eye.

She had diabetes and neurovascular glaucoma in both eyes. Five years ago, she underwent cyclophotocoagulation in the left eye. Visual acuity was counting fingers in both eyes.

Surgery was performed to release flanges and conjunctival fibrosis. An open anterior chamber was not necessary because the valve tube was also extruded.

After surgery, the patient received antibiotics and dexamethasone ointment. The placement of a new valve was not necessary because the eye had phthisis, and the intraocular tension was maintained at 8 mm Hg.

The right eye maintained good tone, and the anterior chamber was consistently maintained. There were no signs of infection during the first month.

Addressing Ahmed valve extrusion necessitates a personalized strategy tailored to the patient's unique clinical situation, encompassing factors such as ocular comorbidities, prior surgical procedures, and overall health condition.

Maintaining excellent conjunctival status is essential. Conditions such as diabetes and permanent inflammation could potentially damage the conjunctiva, leading to complications in the future.

It is imperative to promptly identify and undertake surgical intervention in cases of Ahmed valve extrusion. This proactive approach is vital in averting potential complications, such as infection or compromised regulation of intraocular pressure.