Long-term outcomes of Ahmed ClearPath in childhood glaucoma: four-year results.

Purpose: To evaluate the long-term outcomes of the Ahmed ClearPath (ACP) valveless glaucoma drainage device in childhood glaucoma.

Methods: In this multicenter study, the medical records of all patients ≤18 years of age who underwent ACP implantation and had at least 4 years of follow-up were reviewed retrospectively. The outcome measures included the success rate, reduction in intraocular pressure (IOP), the reduction in glaucoma medications, and the complication rate. Success was defined as achieving a postoperative IOP between 6-21 mm Hg, with or without glaucoma medications, without the need for additional glaucoma surgeries, and without vision-threatening complications.

Results: Nineteen eyes of 17 children were included, with a mean follow-up of 52.4 ± 7.2 months. The mean IOP significantly decreased from 32.2 ± 4.4 mm Hg preoperatively to 14.2 ± 3.7 mm Hg at 1 year, 15.3 ± 4 mm Hg at 2 years, 16 ± 3.8 mm Hg at 3 years, and 16.1 ± 3.1 mm Hg at 4 years (P < 0.001 for all). The median number of glaucoma medications was significantly reduced from 2.5 preoperatively to 1 from year 1 to year 4 postoperatively. Success rates were 90% at 1 year, 84% at 2 years, 79% at 3 years, and 79% at 4 years. At the final follow-up visit, 5 eyes were off glaucoma medications (complete success). No serious vision-threatening complications occurred in any of our patients.

Conclusions: The ACP glaucoma drainage device demonstrated effective long-term control of IOP, reduction in glaucoma medications, and a favorable success rate and safety profile in childhood glaucoma.