Outcomes of the Ahmed clearpath glaucoma drainage device in glaucoma: a systematic review.

purposeTo review the effectiveness and safety of the Ahmed ClearPath (ACP) glaucoma drainage device (GDD) based on current clinical evidence.

methodsA comprehensive literature review was conducted using electronic databases, including PubMed, Embase, the Cochrane Library, Web of Science, and Google Scholar. The search adhered to PRISMA guidelines and encompassed studies published from database inception through June 2025. Eligible articles reported clinical outcomes of ACP implantation in human subjects with primary or secondary glaucomas. Extracted data included intraocular pressure (IOP) reduction, medication burden, complication rates, surgical techniques, and comparative outcomes relative to other GDDs.

resultsThis systematic review included 18 observational studies encompassing a total of 339 eyes implanted with the ACP device. All studies reported substantial and sustained reductions from preoperative IOP, ranging from 43% to 62% over follow-up periods of up to 52 months. Additionally, the median glaucoma medication burden decreased by 71% to 83%, with up to 30% of patients achieving complete freedom from glaucoma medications. Early postoperative adverse events, such as hyphema (15.4%–50%) and inflammation (16.3%–33.3%), were generally mild and self-limited. Reports of persistent hypotony, diplopia, or device erosion were either underreported or rarely reported. Comparative analyses with the Baerveldt Glaucoma Implant indicated comparable or superior surgical effectiveness with fewer perioperative complications. The device’s favorable safety profile was further supported by post-market surveillance data from the FDA Manufacturer and User Facility Device Experience database, which showed low rates of adverse event reporting.

conclusionsACP is an effective and safe GDD for the management of refractory glaucoma in both adult and pediatric patients. While current evidence—primarily based on retrospective clinical series—is promising, broader clinical adoption would benefit from further validation through prospective, controlled studies, particularly those directly comparing ACP to other currently available GDDs. KEY MESSAGES: What is known 1. Glaucoma drainage devices (GDDs) are used in refractory glaucoma and have evolved to improve safety and efficacy. 2. The Ahmed ClearPath (ACP) is a newer, non-valved GDD designed to simplify implantation and improve outcomes. What is new 1. This is the first systematic review evaluating clinical outcomes of the ACP device across 339 eyes from 18 studies. 2. ACP shows consistent and sustained intraocular pressure (IOP) reduction (43–62%) and significant medication burden reduction (71–83%), with a favorable safety profile. 3. Comparative data suggest ACP is at least non-inferior to the Baerveldt Glaucoma Implant, with fewer perioperative complications and promising results in pediatric and complex cases.