AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGV)implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.

METHODS: Forty-four cases(44 eyes)of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP), visual acuity, and complication of post-operation were contrasted with those of pre-operation.

RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes), choroidal detachment(3 eyes), drainage tube shift(1 eye), hyphema(6 eyes), drainage tube blockage(1 eye), expulsive choroidal hemorrhage(1 eye), and fiber wrap of drainage tray(5 eyes).

CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.