LAUSR

PURPOSE To evaluate the outcomes and safety of Ahmed glaucoma valve (AGV) and Baerveldt glaucoma implant (BGI) in childhood glaucoma. METHODS We performed a systematic literature review of publications from 1990-2022 in PubMed, EMBASE, ClinicalTrials.gov, Ovid MEDLINE, Cochrane CENTRAL, and google scholar for studies evaluating AGV and BGI in childhood glaucoma. Primary outcome measures were intraocular pressure (IOP) reduction and glaucoma medication reduction. The secondary outcome measures were the sucess rates and incidence of postoperative complications. We conducted meta-analysis using a random effects model. RESULTS Thirty-two studies met the inclusion criteria. A total of 1480 eyes were included. The mean IOP reduction was 15.08 mmHg (P<0.00001) for AGV and 14.62 (P<0.00001) for the BGI group. The mean difference between pre-and post-operative glaucoma medications was 1 (P<0.00001) fewer medications in the AGV group and 0.95 (P<0.0001) fewer medications in the BGI group. There was a lower success rate in the AGV vs. BGI groups at 2 years (63% vs. 83%, respectively (P<0.0001)) and 3 years (43% vs. 79%, respectively (P<0.0001)); however, the sucess was higher for AGV at 5 years (63% vs. 56% in the BGI group, P<0.001). The incidence of postoperative complications was comparable in the AGV and BGI groups, with rates of 28% and 27%, respectively. CONCLUSION/RELEVANCE The IOP and glaucoma medication reduction, success rates, and incidence of postoperative complications were comparable in both groups. Most literature comes from retrospective low-quality studies on refractory childhood glaucoma. Further larger cohort studies are needed.