Objective: To investigate the success of corneal graft and intraocular pressure (IOP) control after simultaneous penetrating keratoplasty (PKP) and Ahmed glaucoma valve implant in patients with coexisting corneal opacity and glaucoma.

Methods: A retrospective review was undertaken of adult patients at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, who underwent simultaneous PKP and Ahmed glaucoma valve implant between January 1994 and September 1999.

Results: Twenty-five eyes of 25 patients were included in the study. Cumulative probabilities of success by Kaplan-Meier analysis showed 92% and 50% graft success and 92% and 86% IOP control at 1 and 3 years, respectively. The main postoperative complication was graft failure in 10 of 25 cases, and the majority of those failures resulted from immunologic graft rejection and tube endothelial touch.

Conclusions: Ahmed glaucoma valve implant is effective in controlling IOP in a majority of eyes during a 3-year time span. However, corneal graft success continues to pose challenges.