Six-Month Surgical Outcomes of Ahmed ClearPath™ ST250 Implantation in Seven Eyes With Refractory Glaucoma: A Case Series
Abstract
Purpose: The purpose of this study is to evaluate the short-term clinical outcomes of Ahmed ClearPath™ small tube (ST) 250 implantation in patients with refractory glaucoma. Methods: This retrospective study included seven consecutive patients who underwent Ahmed ClearPath™ ST250 implantation at Nagoya University Hospital between December 2025 and April 2026. The primary outcome measure was intraocular pressure (IOP) at six months. Results: The mean age at surgery was 68.7 ± 17.7 years, and the median age was 74 years (range: 42-87 years). Four eyes had primary open-angle glaucoma, and one eye each had glaucoma secondary to retinal detachment surgery, uveitis, and Descemet stripping automated endothelial keratoplasty. Preoperative average IOP was 35.0 ± 6.6 mmHg, and median IOP was 32.0 mmHg (range: 28.0-45.0 mmHg). After Ahmed ClearPathTM ST surgery, IOP decreased to 15.7 ± 9.9 mmHg in one day, median IOP: 12.0 mmHg (range: 5.0-30.0 mmHg), 17.1 ± 12.1 mmHg, median IOP: 11.0 mmHg (range, 6.0-40.0 mmHg) in one week, 13.2 ± 8.2 mmHg, median IOP: 14.0 mmHg (range, 3.0-26.0 mmHg) in two weeks, 10.8 ± 4.1 mmHg, median IOP: 10.5 mmHg (range, 6.0-18.0 mmHg) in one month, 16.2 ± 8.0 mmHg, median IOP: 16.5 mmHg (range: 6.0-28.0 mmHg) in three months, and 11.0 ± 2.7 mmHg, median IOP: 12.0 mmHg (range: 7.0-14.0 mmHg) in six months. Stent removal was performed in five eyes on postoperative days 7, 13, 14, 90, and 90, whereas the stent remained in two eyes throughout the follow-up period. Five of seven patients were glaucoma medication-free after surgery at six months. No shallow or flat anterior chamber, choroidal detachment, suprachoroidal hemorrhage, hypotony maculopathy, or conjunctival leakage were observed. Numerical hypotony, defined as an IOP of <6 mmHg, was observed in two cases but resolved spontaneously without any specific treatment. Conclusions: Ahmed ClearPath ST250 implantation achieved IOP reduction. These findings suggest that Ahmed ClearPath™ ST250 might be a useful surgical option for the management of refractory glaucoma.