Objectives: To evaluate the effectiveness and safety of Ahmed valve surgery in the management of refractory pediatric glaucomas. Patients and Methods: A prospective, interventional study was performed in 2009-2011 at Eye Hospital of Ho Chi Minh city. Success was defined as a reduction of the intraocular pressure between 5-21mmHg with or without medications at the last two follow-up visits, no loss of light perception, and no further surgical intervention for glaucoma. lntra- and post-operative complications were recorded. Results: There were 25 eyes of 25 recurrent glaucoma children with the average age 85.32 + or - 61.89 months (1-189 months) implanted Ahmed glaucoma valves. The mean follow-up time was 29.08 + or - 6.41 months (6-36 months). The mean IOP decreased from 31.20 + or - 4.64mmHg (24-43mmHg) to 20.24 + or - 5.84mmHg (p0.001) with an overall success rate of 76.0 percent at last follow-up. Kaplan-Meier analysis showed cumulative probabilities of success of 84 percent, 76 percent and 76 percent after 1, 2, and 3 years follow-up. The average number of medications used decreasedfrom 2.60 + or - 0.65 to 1.28 + or - 1.10 (p0.001). Complications were reported in 13 eyes (52.0 percent). No complication such as graft rejection, graft infection, or tube erosion was observed with the use of dehydrated scleral patch grafts to cover the tubes. Conclusion: Ahmed glaucoma valve implantation is an effective treatment for refractory pediatric glaucoma. Dehydrated scleral patch grafts appeared to be well tolerated and can be used as tube coverage in the implanted glaucoma drainage devices.
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