Assessment of Closing Pressure in Silicone Ahmed FP7 Glaucoma Valves

Purpose: To measure closing pressure in a series of new Model FP7 silicone Ahmed Glaucoma Valves (AGVs), using an in vitro gravity-driven system, in which closing pressure was measured directly from a dual manometer/pressure reservoir.

Method: A straight length of tubing served as an open manometer, which connected via a 3-way stopcock to the inlet of the AGV submerged under 1.5 cm of balanced saline solution (BSS). Six AGV were assessed in 5 sequential trials and the mean inlet pressure at 90 minutes was recorded as the closing pressure. After testing, a single valve was primed a second time using greater force and retested. Control trials were performed with a submerged 26-G cannula opening directly into the BSS bath.

Results: At 90 minutes, the 6 valves equilibrated at a mean inlet pressure of 7.1 mm Hg, with a range from 1.4 to 13.5 mm Hg. Closing pressures at or less than 5 mm Hg were measured in half (3/6) of the valves tested. The average flow of BSS across the valves in the final 30 minutes was less than 1.5x10(-2) microL/min. In the single valve reperfused under greater pressure, the closing pressure increased.

Conclusions: Model FP7 AGVs, in vitro, exhibit significant variability in closing pressure, with half closing at intraocular pressures considered potentially problematic in clinical situations. The results of the high-pressure perfusion experiment suggest that more research into the priming process is required so a precise description can be developed for surgeons.