Mitomycin-C Trabeculectomy versus Ahmed Glaucoma Implant in Pediatric Aphakic Glaucoma

Purpose: to compare the outcomes and complications of mitomycin-c trabeculectomy(mmc-t) versus the ahmed glaucoma implant (agi) for treatment of pediatric aphakicglaucoma.methods: in a randomized clinical trial, 30 eyes of 28 children <16 years of age who hadundergone anterior lensectomy-vitrectomy for congenital cataract were assigned tommc-t (15 eyes of 13 children) or agi (15 eyes of 15 children). surgical success wasclassified as complete (iop 6-21 mmhg without any antiglaucoma medication) andpartial (iop 6-21 mmhg with <2 topical antiglaucoma agents) in the absence of anysight-threatening complication or need for further glaucoma surgery, stable cup/discratios and visual loss <2 snellen lines. overall success was defined as the sum ofcomplete and partial success.results: mean patient age was 9.1±4.1 and 10.9±5.1 years in the mmc-t and agigroups, respectively (p=0.29). after a mean follow up of 14.8±11 and 13.1±9.7 months;complete, partial and overall success rates were 33.3%, 40% and 73.3% in the mmc-t vs20%, 66.7% and 86.7% in the agi groups, respectively (p= 0.361). complication andfailure rates were 40% and 26.7% in the mmc-t group vs 26.7% and 13.3% in the agigroup, respectively (p= 0.439).conclusion: mmc-t and agi seem to be comparable in terms of success andcomplications as the initial surgical procedure in pediatric aphakic glaucoma. choice ofeither technique depends on surgeon’s experience and conjunctival quality andmobility.