Budenz D L, Sakamoto D, Eliezer R, Varma R, Heuer D K
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida 33136, USA.
Ophthalmology. 2000 Nov;107(11):2105-10. doi: 10.1016/s0161-6420(00)00381-x.
To report the outcome and complications of 10 eyes of 9 children with Sturge-Weber syndrome (SWS) who underwent two-stage insertion of a Baerveldt glaucoma implant (BGI) for glaucoma.
Retrospective noncomparative case series.
The authors reviewed the medical records of children under the age of 14 years with SWS who underwent two-stage BGI for glaucoma at two tertiary care referral centers.
Intraoperative and postoperative complications, intraocular pressure (IOP), number of glaucoma medications, visual acuity, and further surgical intervention.
Ten eyes of nine patients were included in the study. Ages of the nine patients at time of first stage BGI ranged between 6 weeks and 13 years. With average follow-up of 35 months (range, 10-50), all eyes had adequate IOP control (< or = 21 mmHg) without the need for additional glaucoma surgery. Intraocular pressure was reduced from a mean (+/- standard deviation) of 24.8 +/- 6.2 mmHg preoperatively to 16.9 +/- 2.3 mmHg at last follow-up visit (P = 0.001). The number of medications used for control of glaucoma was reduced from a mean (+/- standard deviation) of 1.8 +/- 1.0 preoperatively to 1.1 +/- 1.4 at last follow-up visit (P = 0.2). One eye had serous choroidal effusions with overlying serous retinal detachment that resolved spontaneously after 7 days with no permanent visual loss, and one eye had low choroidal effusion that lasted 4 days. There were no intraoperative or postoperative suprachoroidal hemorrhages. At last follow-up, visual acuity had improved by one or more lines in all patients in whom vision was measurable.
Two-stage BGI surgery appears to be a safe and effective treatment for refractory glaucoma in children with SWS.
报告9例患有斯-韦综合征（SWS）的儿童的10只眼睛，接受两阶段植入Baerveldt青光眼植入物（BGI）治疗青光眼的结果及并发症。
回顾性非对照病例系列。
作者回顾了在两个三级医疗转诊中心接受两阶段BGI治疗青光眼的14岁以下SWS儿童的病历。
术中及术后并发症、眼压（IOP）、青光眼药物使用数量、视力及进一步的手术干预。
9例患者的10只眼睛纳入研究。第一阶段BGI植入时，9例患者的年龄在6周至13岁之间。平均随访35个月（范围10 - 50个月），所有眼睛的眼压均得到充分控制（≤21 mmHg），无需额外的青光眼手术。眼压从术前平均（±标准差）24.8±6.2 mmHg降至最后一次随访时的16.9±2.3 mmHg（P = 0.001）。用于控制青光眼的药物数量从术前平均（±标准差）1.8±1.0降至最后一次随访时的1.1±1.4（P = 0.2）。一只眼睛出现浆液性脉络膜脱离伴上方浆液性视网膜脱离，7天后自发消退，无永久性视力丧失，另一只眼睛出现低度脉络膜脱离，持续4天。术中及术后均无脉络膜上腔出血。在最后一次随访时，所有可测量视力的患者视力均提高了一行或多行。
两阶段BGI手术似乎是治疗SWS儿童难治性青光眼的一种安全有效的方法。
