Ahmed glaucoma valve augmented with mitomycin C and amniotic membrane as a first intervention in advanced primary congenital glaucoma

Abstract

The goal of this study is to assess the effectiveness of implantation of an Ahmed glaucoma valve (AGV) augmented with the use of mitomycin-C (MMC) and preserved amniotic membrane (AM), as a first line of intervention in cases of advanced primary congenital glaucoma (PCG). Prospective clinical and interventional trial was done on 30 eyes of 24 patients, aged between 6 months and 3 years, with advanced PCG at presentation. AGV (model FP8) implantation augmented with use of MMC and two layers of cryopreserved human AM as a primary intervention. At all-time intervals (at day 1, 1, 3, and 12 months following surgery), the postoperative intraocular pressures (IOPs) were significantly lower than the preoperative IOPs (16.83±2.78 mmHg at month 12 compared with a preoperative IOP of 38.29±4.23 mmHg). At all times, the postoperative corneal diameter was not noticeably smaller than the preoperative values (13.79±0.57 mm at month 12 compared with preoperative value of 13.93±0.58 mm). AGV augmented with the use of MMC and AM can be considered as a secure and reliable approach for management of cases of advanced PCG, without additional risks compared with other techniques.