Comparison Between Ahmed Glaucoma Valve Vs Paul Glaucoma Implant In Management Of Aphakic Glaucoma
Published 2025 - 43rd Congress of the ESCRS
Reference: PO308 | Type: Free paper | DOI: 10.82333/n45w-zt10
Authors: Luigi Serra 1 , Michele Lanza* 1 , Rosa Boccia 1 , Salvatore Ambrosio 1 , Italo Fattore 1 , Francesco Abbate 1 , Teresa Cangiano 1 , Francesca Agricola 1 , Francesca Simonelli 1
1Dipartimento Multidisciplinare di Specialità Mediche, Chirurgiche ed Odontoiatriche,Università della Campania Luigi Vanvitelli,Napoli,Italy
Purpose
Congenital cataract has a risk of devoloping aphakic glaucoma on the long run and conotrolling intraocular pressure is essinial part in management. Thus, in case of aphakic glaucoma the choice of Paul Glaucoma Implant (PGI) resulted in better visual outcomes compared to Ahmed Glaucoma valve (AGV). Both devices effectively controlled IOP, but PGI may offer better long-term results.
Setting
This case is a 15 years old male patient, whom is following in King Khaled Eye Specialist Hospital and Research Center, in Riyadh, Saudi Arabia.
Methods
A case report. The case eliminates bias since the patient was his own control and operated by same surgeon on the right eye followed by the left eye. A case of a 15-year-old male with congenital cataracts and aphakic glaucoma presented with uncontrolled IOP despite medical treatment. The right eye was treated with AGV, and the left with PGI.
Both AGV and PGI were effective in controlling IOP, but PGI provided more stable visual outcomes than AGV. While studies have shown similar IOP reductions for both devices. PGI may be advantageous in terms of fewer complications and better long-term vision outcomes. This case highlights GDDs' potential in managing aphakic glaucoma, especially in pediatric patients where maintaining VA is crucial.
Results
The patient udenwent AGV in the right eye, followed by PGI in the left eye a couple of years later. The two surgeries were done by same surgeon. Both tubes demonstrated a favorable outcome, with the last visit's visual acuity being 3/200 and 20/300 and IOP being 10 mmHg and 9 mmHg in the right and left eye, respectively, which is the same Visual Aquity (VA) as pre-operatively. He was consistently followed up for a period of approximately four years. He showed a favorable outcome with a different tube implanted in each eye. To our knowledge, such a case has yet to be reported in the literature.
Conclusions
In this case report, both glaucoma implants (AGV, PGI) showed reasonable IOP control. However, PGI demonstrated a better visual prognosis compared to the Ahmed implant in a patient with aphakic glaucoma. Further studies with larger sample sizes and more extended follow-up periods are warranted to establish definitive conclusions and recommendations for surgical management in cases of aphakic glaucoma in pediatric age group.