Sturge weber's syndrome is an oculcutaneous syndrome, ocular manifestations may include
heamangioma in the eye lids, choroidal heamangioma, or glaucoma, the glaucoma may present at
infancy and may be due to resistance to aqueous outflow through trabecular meshwork(1), it
may develop later and this is due to episcleral venous raised pressure.(2-3) Glaucoma
associated with Sturge weber syndrome is difficult to be treated medically with high risk of
complications when treated with bleb -based surgeries. Suprachoroidal hemorrhage or
detachment is a challenging complication which must be encountered.
The usage of Ahmed valve in the management of glaucoma associated with Sturge weber syndrome
is a bleb based procedure carries the risks of over filtration or encapsulation and decreased
filtration with failure to control glaucoma.
The use of Ahmed valve in the management of pediatric glaucoma associated with Sturge weber
syndrome has better results as recorded by Nassiri et al. Ahmed valve implantation can have
some drawbacks such as pupillary irregularity, lens opacification, or encapsulation.(4-7)
Glaucoma drainage devices such as Ahmed valve, Molteno or Braeveldt valve can be used when
other methods of treatment fail, they provide alternative pathway to the aqueous to be
collected in a plate positioned under the conjunctiva, (8-10) Encapsulation is a major
problem occurs around the end plate due to fibrous reaction and so the drainage of the
aqueous is decreased , Epatein (11) attributed that to fibro vascular proliferation in the
episcleral tissue .the fibrous reaction is multifactorial , it may be due to the size of the
end plate, the biomaterial, design or the shape of the plate.
The use of drainage devices with advanced drug delivery system can improve the success of
drainage device.
A double-layered porous coating for Ahmed glaucoma valves based on biodegradable
poly(lactic-co-glycolic acid) (PLGA) was described by Ponnusamy et al. [12] to produce
continuous release of antifibrotic agents [mitomycin C (MMC) and/or 5-fluorouracil (5-FU)] to
the subconjunctival space. This release continue for about one month with decreasing
fibrosis, the nanofiltration membrane could entrap the proteins passing out from the anterior
chamber leading to minimal increase in aqueous resistance.(12-13)