Table 1.
Characteristics of the 32 studies included in the meta-analysis of efficacy of Ahmed and Baerveldt drainage devices in childhood glaucoma
| First Author | Year | Study Design | Number of Eyes | Number of Patients | Age in Years at Time of Valve Implantation Mean (SD) | Follow-Up in Months Mean (SD) | Gender Male:Female | Valves Studied | Etiologies Studieda | Prior Glaucoma Surgery | Baseline IOP Mean (SD) | Baseline number of medications Mean (SD) | IOP, Final Follow-Up Mean (SD) | Number of Medications, Final Follow-Up Mean (SD) | Success Criteriab |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Balekudaru et al. | 2014 | Retrospective | 71 | 71 | 6.8 (4.9) | 37.8 (32.1) | 40:31 | Ahmed FP7, S2 | Primary, GFCS, Secondary | Yes | 35.86 (9.6) | 2.42 (1) | 16.4 (8.7) | 1.3 (1.1) | IOP 6–18 with (qualified) or without (complete) medications, without loss of LP vision or loss of vision due to complication |
| Banitt et al. | 2009 | Retrospective | 30 | 30 | 6.9 (5) | 29.8 (26.4) | 14:16 | Baerveldt 250, 350, 425 | Primary, GFCS, Secondary | Yes | 32.9 (7.9) | 3 (1.6) | IOP 5–21 with or without medications and without additional glaucoma surgery or loss of LP vision | ||
| Budenz et al. | 2000 | Retrospective | 10 | 9 | 6.6 (4.3) | 32.9 (12.1) | 6:3 | Baerveldt 250, 350, 425 | Secondary | Yes | 24.8 (6.2) | 1.8 (1) | 16.9 (2.3) | 1.1 (1.4) | IOP ≤ 21 with or without medications and without additional glaucoma surgery |
| Chen et al. | 2015 | Retrospective | 119 | 89 | 6.8 (5.7) | 73.2 (39.6) | 61:58 | Ahmed FP7, S2 | Primary, Secondary | Yes | 29.2 (9.7) | 2.2 (1.3) | IOP 5–21 and ≥ 20% reduction from baseline IOP with or without medications | ||
| Das et al. | 2005 | Retrospective | 30 | < 12 years | Ahmed S2 | Yes | 32.4 (4.5) | IOP 6–22 and ≥ 30% reduction from baseline IOP with (qualified) or without (complete) medications and without additional glaucoma surgery or visually devastating complications | |||||||
| Dave et al. | 2015 | Retrospective | 11 | 8 | 1.3 (0.4) | 17.9 (9.3) | 4:4 | Ahmed FP8 | Primary | Yes | 28 (5.7) | 2.6 (0.5) | 13.6 (3.4) | 1.6 (0.9) | IOP 6–18 with a maximum of 3 medications (qualified) or without medications (complete) |
| Djodeyre et al. | 2001 | Retrospective | 35 | 29 | 4.4 (4.7) | 12.6 (10.8) | 18:17 | Ahmed S2, S3 | Primary, GFCS, Secondary | Yes | 28.8 (4.5) | 18.1 (2.4) | IOP ≤ 21 with (qualified) or without (complete) medications without signs of progression, additional glaucoma surgery, or devastating complications. Surgical valve revision considered partial success | ||
| Eksioglu et al. | 2017 | Retrospective | 16 | 11 | 14.2 (3.3) | 64.5 (33.6) | 8:3 | Ahmed FP7, S2 | Secondary | Yes | 33.5 (7.3) | 3 (0) | 12.7 (3.2) | 1.0 (1.2) | IOP 6–21 with (qualified) or without (complete) medications and without additional glaucoma surgery or tube extraction surgery |
| El Sayed et al. - Silicone | 2013 | Prospective | 25 | 2.9 (5.4) | Ahmed FP7, FP8 | Primary, GFCS, Secondary | Yes | 33.8 (5.6) | 2.93 (0.7) | IOP ≤ 21 with (qualified) or without (complete) medications and no signs of glaucoma progression | |||||
| El Sayed et al. – Polypropylene | 2013 | Prospective | 25 | 2.8 (5.6) | Ahmed S2, S3 | Primary, GFCS, Secondary | Yes | 34.1 (5.9) | 2.8 (0.7) | IOP ≤ 21 with (qualified) or without (complete) medications and no signs of glaucoma progression | |||||
| Esfandiari et al. - Ahmed | 2019 | Retrospective | 16 | 16 | 4.4 (2.1) | 9:7 | Ahmed FP7 | GFCS | Yes | 28.6 (4.1) | 3 (0.2) | 17.6 (2.1) | IOP 5–21 and ≥ 20% reduction from baseline IOP with or without medications, without additional glaucoma surgery | ||
| Esfandiari et al. - Baerveldt | 2019 | Retrospective | 12 | 12 | 4.1 (1.2) | 7:5 | Baerveldt 350 | GFCS | Yes | 30 (4.1) | 3.1 (1.8) | 17.6 (1.7) | IOP 5–21 and ≥ 20% reduction from baseline IOP with or without medications, without additional glaucoma surgery | ||
| Geyer et al. | 2021 | Retrospective | 41 | 27 | 7.9 (7.3) | 61.1 (46.5) | Ahmed FP7 | GFCS | Yes | 35.8 (7.4) | 3.1 (1.3) | 18.7 (6.5) | 1.6 (1) | IOP ≤ 22 with (qualified) or without (complete) medications, without additional glaucoma surgery or visually devastating complications | |
| Helmy et al. | 2016 | RCT | 33 | 33 | 1.28 (0.5) | 17:16 | Ahmed FP8 | Primary | Yes | 33.4 (4.5) | 2.1 (0.4) | IOP 7–21 with (qualified) or without (complete) additional medications, without additional glaucoma surgery, with stable corneal diameter, cup to disc ratio, and stable or improving corneal edema or clarity | |||
| Huang et al. | 2015 | Retrospective | 14 | 11 | 4.3 (1.9) | 18.3 (11) | 7:4 | Ahmed FP7, FP8 | Primary | Yes | 39.5 (5.7) | IOP 6–21 and ≥ 30% reduction from baseline IOP, without additional glaucoma surgery, loss of LP vision, or serious complications | |||
| Karaconji et al. | 2020 | Retrospective | 6 | 5 | 6.6 (5.4) | 39.3 (25.6) | Baerveldt 350 | Secondary | Yes | 29 (1.7) | 3 | 15.6 (5.4) | IOP ≤ 21 with (qualified) or without (complete) medications and stable optic disc appearance. IOP ≤ 21 with stent removal also defined as qualified success | ||
| Khan et al. - Polypropylene | 2009 | Retrospective | 31 | 31 | 0.9 (0.5) | 17:14 | Ahmed S1, S2 | Primary, GFCS, Secondary | Yes | 33.4 (9.7) | 2.5 (0.7) | IOP ≤ 22 with (qualified) or without (complete) medications, without visually devastating complications | |||
| Khan et al. – Silicone | 2009 | Retrospective | 11 | 11 | 1.2 (0.5) | 5:6 | Ahmed FP7 | Primary | Yes | 33.9 (4.9) | 3.1 (1.1) | IOP ≤ 22 with (qualified) or without (complete) medications, without visually devastating complications | |||
| Kirwan et al. | 2005 | Retrospective | 19 | 13 | 8 | 32 | 7:6 | Ahmed S2 | GFCS | Yes | 31.1 (4.3) | 13 (3.5) | IOP ≤ 15 with (qualified) or without (complete) medications | ||
| Lee et al. | 2015 | Retrospective | 11 | 7.1 (7.2) | 94.6 (28.4) | Ahmed FP8, S3 | Primary | Yes | 26.9 (6.9) | 1.7 (1.1) | IOP 5–12 with (qualified) or without (complete) medications, without additional glaucoma surgery or loss of vision due to complication | ||||
| Mahdy et al. – Ahmed+MMC | 2011 | RCT | 20 | 14 | 4 (5) | 6:8 | Ahmed S3 | Primary | Yes | 32 (3.5) | IOP 10–21 with (qualified) or without (complete) medications, without additional glaucoma surgery, loss of LP vision, or devastating complications | ||||
| Mahdy et al. – Ahmed | 2011 | RCT | 20 | 18 | 5 (4) | 10:8 | Ahmed S3 | Primary | Yes | 35.1 (4) | IOP 10–21 with (qualified) or without (complete) medications, without additional glaucoma surgery, loss of LP vision, or devastating complications | ||||
| Mofti et al.c | 2020 | Retrospective | 178 | 178 | 5.8 (5.5) | 55.2 (37.2) | 89:89 | Ahmed F7, F8, S2 | Primary, GFCS, Secondary | Yes | 32 (27.8–36.3) | 3.5 (2.5–4.5) | 3 | IOP 5–21 without medications, without additional glaucoma surgery | |
| Mokbel et al. | 2019 | Retrospective | 14 | Ahmed, unspecified type | Primary | No | 36.6 (6.6) | IOP 6–21 with (qualified) or without (complete) medications, with stable ocular biometric measurements | |||||||
| Morad et al. | 2003 | Retrospective | 60 | 44 | 6 (4.9) | 24.3 (16) | 25:19 | Ahmed, unspecified type | Primary, GFCS, Secondary | Yes | 32.8 (6.2) | 4.5 (2.0) | 16.6 (8) | 2 (2) | IOP 5–21 with (qualified) or without (complete) medications, without signs of glaucoma progression or loss of > 2 Snellen lines of visual acuity secondary to implant |
| Novak-Laus et al. | 2016 | Retrospective | 10 | 9 | < 11 years | ≥ 12 months | 6:4 | Ahmed S3 | Primary, GFCS, Secondary | Yes | 31.4 (4.5) | 19.3 (5.6) | 1.1 (1.0) | IOP 6–21 with (qualified) or without (complete) medications, without loss of vision due to complications | |
| O’ Malley Schotthoefer et al.d | 2008 | Retrospective | 38 | 30 | 0.75 (0.2–15) | 66 (6–126) | Ahmed FP7, S2, Baerveldt 250, 350 | Primary | Yes | 28.5 (8–44) | 3 (0–5) | 17 (4–40) | 3 (0–4) | IOP ≤ 21 with (qualified) or without (complete) medications, without additional glaucoma surgery or severe complications | |
| Ou et al. | 2009 | Retrospective | 39 | 19 | 1.9 (2.6) | 57.6 (48) | 12:7 | Ahmed FP7, S2 | Primary | Yes | 28.4 (6.7) | 0.9 (0.7) | IOP 6–22 and ≥ 15% reduction from baseline IOP | ||
| Pakravan et al. | 2007 | RCT | 15 | 15 | 10.9 (5.1) | 13.1 (9.7) | 12:3 | Ahmed, unspecified type | GFCS | No | 32.8 (8.6) | 3.3 (0.5) | 14.1 (4.5) | 1.3 (1.0) | IOP 6–21 with no more than two (qualified) or without (complete) medications |
| Promelle et al. | 2021 | Retrospective | 81 | 63 | 6.4 (5.1) | 96 (60) | 35:28 | Ahmed FP7, S2 | Primary, GFCS, Secondary | Yes | 30.4 (8.1) | 3 (1.4) | 19.9 (6.8) | 1.5 (1.4) | IOP 5–21 with (qualified) or without (complete) medications |
| Razeghinejad et al. | 2014 | Retrospective | 33 | 22 | 2.7 (3.1) | 32.6 (18.3) | 17:5 | Ahmed FP7, FP8, S2, S3 | Primary | Yes | 32.8 (7.3) | 2.5 (0.7) | 16.8 (4) | 2.2 (0.7) | IOP 6–21 with (qualified) or without (complete) medications |
| Rolim-de-Moura et al. | 2020 | RCT | 5 | 5 | 3.4 (2.6) | 4:1 | Baerveldt 250 | Primary | Yes | 22.8 (4.9) | 2.6 (0.5) | IOP 6–21 with (qualified) or without (complete) medications | |||
| Senthil et al. – PCGc | 2018 | Retrospective | 24 | 2 (1.5–3) | 26 (12–40) | Ahmed FP7, FP8 | Primary | Yes | 29 (28–33) | 3.5 (2.5–4) | 14.6 (11–18) | 2 (1.5–2) | IOP 6–21 with (qualified) or without (complete) medications | ||
| Senthil et al. – Secondary Glauomac | 2018 | Retrospective | 41 | 9 (2–13) | 27.8 (16.4–37.9) | Ahmed FP7, FP8 | Secondary | Yes | 30 (26–35) | 3 (3–4) | 15.4 (13–18) | 2 (1–2) | IOP 6–21 with (qualified) or without (complete) medications | ||
| Soyugelen et al. | 2019 | Retrospective | 3 | 3 | 9 (4.6) | 24 (10.8) | 3:0 | Ahmed FP7, S2 | Secondary | No | 34 (14.4) | 3.3 (1.2) | IOP 5–22 with or without medications | ||
| Speiss et al.c | 2021 | Retrospective | 29 | 23 | 85.4 (56.2) | 10:13 | Ahmed FP7, FP8, S2 | GFCS | No | 32.6 (6.7) | 2 (2–3) | IOP ≤ 21 with (qualified) or without (complete) medications, without loss of LP vision or devastating complications | |||
| Tai et al. | 2014 | Retrospective | 45 | 36 | 4.3 (4.8) | 26:19 | Baerveldt 350 | Primary, GFCS, Secondary | Yes | 31.6 (5) | 3 (1.2) | IOP 6–21 with or without medications, without additional glaucoma surgery or devastating complications |
a
Etiologies studied classified according to International Consensus Classification (Thau et al. 2018): “primary glaucoma” includes primary congenital glaucoma and juvenile open angle glaucoma. Glaucoma following cataract surgery (GFCS) was classified separately. All other secondary glaucomas aside from glaucoma following cataract surgery were classified into “secondary glaucoma”.
b
In studies where success criteria were defined separately for qualified or complete success, total success was extracted (combining rates of both qualified and complete success).
Data expressed in mean (standard deviation) unless otherwise specified
c
Data expressed in median (interquartile range)
d
Data expressed in median (range)
Abbreviations: SD (standard deviation); LP (light perception); IOP (intraocular pressure); RCT (randomized controlled trial); GFCS (glaucoma following cataract surgery)