Ahmed valve surgery for secondary post-traumatic glaucoma in aniridia patients

Relevance. Secondary post-traumatic glaucoma (PTG) in patients with aniridia presents a complex clinical challenge due to severe anatomical changes in the eye’s drainage system. Standard glaucoma surgeries show limited efficacy, necessitating alternative treatment approaches. The use of the Ahmed glaucoma valve (AGV) is of particular interest; however, there is insufficient evidence on its effectiveness in PTG associated with aniridia, especially in Russian ophthalmology. Purpose. To evaluate the hypotensive effect and dynamics of visual function after Ahmed glaucoma valve (AGV) implantation in patients with aniridia and secondary posttraumatic glaucoma. Material and methods. This study included 20 patients (20 eyes) with aniridia and uncontrolled PTG despite maximal hypotensive therapy. Intraocular pressure (IOP) dynamics, visual function, and postoperative complications were assessed over 18 months. Results. The AGV implantation led to a statistically significant reduction in IOP (p<0.001), with target IOP levels (<21 mm Hg) achieved in 85% of patients by 18 months. Among the complications, encapsulation of the valve plate was observed in 15% of patients and tube occlusion in 5%; both were successfully managed by revision of the filtering area. Hypotony (10%) and hyphema (5%) were also noted but did not require additional surgical intervention. Endothelial cell density decreased by 12%; however, visual function remained stable. Conclusion. Ahmed glaucoma valve implantation is an effective method for IOP control in patients with posttraumatic glaucoma and aniridia, providing long-term stabilization of ocular pressure. However, the complex anatomy of these patients and the high risk of complications necessitate further refinement of surgical techniques and the development of individualized management protocols. Keywords: secondary post-traumatic glaucoma, aniridia, Ahmed glaucoma valve implantation.