对接受艾哈迈德青光眼引流阀植入术的原始队列进行随访。

Follow-up of the original cohort with the Ahmed glaucoma valve implant.

作者信息

Topouzis F, Coleman A L, Choplin N, Bethlem M M, Hill R, Yu F, Panek W C, Wilson M R

机构信息

Jules Stein Eye Institute, University of California, Los Angeles, School of Medicine, 90095-7004, USA.

出版信息

Am J Ophthalmol. 1999 Aug;128(2):198-204. doi: 10.1016/s0002-9394(99)00080-x.

DOI:10.1016/s0002-9394(99)00080-x

PMID:10458176

Abstract

PURPOSE

To study the long-term results of the Ahmed glaucoma valve implant in patients with complicated glaucoma in whom short-term results have been reported.

METHODS

In this multicenter study, we analyzed the long-term outcome of a cohort of 60 eyes from 60 patients in whom the Ahmed glaucoma valve was implanted. Failure was characterized by at least one of the following: intraocular pressure greater than 21 mm Hg at both of the last two visits less than 6 mm Hg at both of the last two visits, loss of light perception, additional glaucoma surgery, devastating complications, and removal or replacement of the Ahmed glaucoma valve implant. Devastating complications included chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis, and phthisis bulbi; we also report results that add corneal complications (corneal decompensation or edema, corneal graft failure) as defining a devastating complication.

RESULTS

The mean follow-up time for the 60 eyes was 30.5 months (range, 2.1 to 63.5). When corneal complications were included in the definition of failure, 26 eyes (43%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 76%, 68%, 54%, and 45%, respectively. When corneal complications were excluded from the definition of failure, 13 eyes (21.5%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 87%, 82%, 76%, and 76%, respectively. Most of the failures after 12 months of postoperative follow-up were because of corneal complications.

CONCLUSIONS

The long-term performance of the Ahmed glaucoma valve implant is comparable to other drainage devices. More than 12 months after the implantation of the Ahmed glaucoma valve implant, the most frequent adverse outcome was corneal decompensation or corneal graft failure. These corneal problems may be secondary to the type of eyes that have drainage devices or to the drainage device itself. Further investigation is needed to identify the reasons that corneal problems follow drainage device implantation.

摘要

目的

研究已报道短期结果的复杂性青光眼患者植入艾哈迈德青光眼引流阀的长期效果。

方法

在这项多中心研究中，我们分析了60例患者的60只眼植入艾哈迈德青光眼引流阀后的长期结果。失败的定义为以下至少一项：最后两次就诊时眼压均大于21 mmHg、最后两次就诊时眼压均小于6 mmHg、光感丧失、再次进行青光眼手术、严重并发症以及取出或更换艾哈迈德青光眼引流阀植入物。严重并发症包括慢性低眼压、视网膜脱离、恶性青光眼、眼内炎和眼球痨；我们还报告了将角膜并发症（角膜失代偿或水肿、角膜移植失败）定义为严重并发症时的结果。

结果

60只眼的平均随访时间为30.5个月（范围为2.1至63.5个月）。当将角膜并发症纳入失败定义时，26只眼（43%）被视为失败。1年、2年、3年和4年的累积成功率分别为76%、68%、54%和45%。当将角膜并发症排除在失败定义之外时，13只眼（21.5%）被视为失败。1年、2年、3年和4年的累积成功率分别为87%、82%、76%和76%。术后随访12个月后的大多数失败是由于角膜并发症。