Br J Ophthalmol 89:454-458 doi:10.1136/bjo.2004.049015
  • Clinical science
    • Extended reports

Endophthalmitis associated with the Ahmed glaucoma valve implant

  1. A A Al-Torbak1,
  2. S Al-Shahwan1,
  3. I Al-Jadaan1,
  4. A Al-Hommadi2,
  5. D P Edward3
  1. 1Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  2. 2Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  3. 3Department of Ophthalmology, University of Illinois, Chicago, IL, USA
  1. Correspondence to: Abdullah A Al-Torbak MD FRCS, King Khaled Eye Specialist Hospital, PO Box 7191 Riyadh 11462, Saudi Arabia;
  • Accepted 1 September 2004


Aim: To investigate the rate, risk factors, clinical course, and treatment outcomes of endophthalmitis following glaucoma drainage implant (GDI) surgery.

Methods: A computerised relational database search was conducted to identify all patients who were implanted with Ahmed glaucoma valve (AGV) and developed endophthalmitis following surgery at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, between 1 January 1994 and 30 November 2003. Only medical records of the patients who developed endophthalmitis were retrospectively reviewed.

Results: 542 eyes of 505 patients who were on active follow up were included in the study. Endophthalmitis developed in nine (1.7%) eyes; the rate was five times higher in children than in adults. Delayed endophthalmitis (developed 6 weeks after surgery) occurred in eight of nine eyes. Conjunctival erosion overlying the AGV tube was present in six of nine eyes. Common organisms isolated in the vitreous included Haemophilus influenzae and Streptococcus species. Multiple regression analysis revealed that younger age and conjunctival erosion over the tube were significant risk factors associated with endophthalmitis.

Conclusion: Endophthalmitis is a rare complication of GDI surgery that appears to be more common in children. Conjunctival dehiscence over the GDI tube seems to represent a major risk factor for endophthalmitis. Prompt surgical revision of an exposed GDI tube is highly recommended.


  • Presented in part as a paper at the annual meeting of the Saudi Ophthalmological Society, 2–5 March 2003, Riyadh, Saudi Arabia.

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