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10例虹膜角膜内皮综合征患者房水引流手术的长期疗效

Long-term outcome of aqueous shunt surgery in ten patients with iridocorneal endothelial syndrome.

作者信息

Kim D K, Aslanides I M, Schmidt C M, Spaeth G L, Wilson R P, Augsburger J J

机构信息

Glaucoma Service, University of Florida, Jacksonville, USA.

出版信息

Ophthalmology. 1999 May;106(5):1030-4. doi: 10.1016/S0161-6420(99)00529-1.

Abstract

PURPOSE

To report the long-term outcome of ten patients with iridocorneal endothelial (ICE) syndrome who underwent aqueous shunt surgery for uncontrolled glaucoma.

DESIGN

Noncomparative, retrospective case series.

PARTICIPANTS

The authors reviewed charts of ten patients with ICE syndrome-related glaucoma who underwent aqueous shunt surgery at one institution between 1987 and 1996.

MAIN OUTCOME MEASURES

Intraocular pressure (IOP), number of glaucoma medications, and further surgical interventions were measured.

RESULTS

With a median follow-up of 55 months, four eyes had adequate IOP control (IOP <21 mm Hg) with one or two medications after the initial aqueous shunt surgery. An additional three eyes achieved adequate IOP control after one or more tube repositionings or revisions of the initial aqueous shunt. In this series, the aqueous shunt surgery most often failed because of blocking of the tube ostium by iris, ICE membrane, or membrane-induced tube migration.

CONCLUSION

Aqueous shunt surgery appears to be an effective method for IOP lowering in some eyes with ICE syndrome-related glaucoma when medical treatment or conventional filtration surgeries fail, but additional glaucoma procedures and/or aqueous shunt revisions and tube repositionings are not uncommon.

摘要

目的

报告10例虹膜角膜内皮(ICE)综合征患者因青光眼控制不佳而接受房水引流手术的长期结果。

设计

非对照性回顾性病例系列。

参与者

作者回顾了1987年至1996年间在一家机构接受房水引流手术的10例ICE综合征相关性青光眼患者的病历。

主要观察指标

测量眼压(IOP)、青光眼药物使用数量以及进一步的手术干预情况。

结果

中位随访55个月,4只眼在初次房水引流手术后使用一种或两种药物即可使眼压得到充分控制(眼压<21 mmHg)。另外3只眼在进行一次或多次引流管重新定位或初次房水引流手术修正后眼压得到充分控制。在该系列中,房水引流手术最常见的失败原因是虹膜、ICE膜或膜导致的引流管移位阻塞引流管口。

结论

当药物治疗或传统滤过手术失败时,房水引流手术似乎是降低某些ICE综合征相关性青光眼患者眼压的有效方法,但额外的青光眼手术和/或房水引流手术修正及引流管重新定位并不少见。

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