Lim Kin Sheng, Wells Anthony P, Khaw Peng T
Wound Healing and Glaucoma Research Units, Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom.
J Glaucoma. 2002 Oct;11(5):434-8. doi: 10.1097/00061198-200210000-00012.
To investigate the effects of needle perforation of proximal Molteno tubes on intraluminal pressure in a constant flow system.
Balanced salt solution was infused at a rate of 2 microL/min through nonexpansile silicon tubing attached to a manometric reservoir, pressure transducer, and an occluded proximal Molteno glaucoma drainage device tube. As the intraluminal pressure rose to approximately 30 mm Hg, the tube was perforated once with needles ranging in size from 23G to 29.5 G (disposable insulin syringe). Intraluminal pressure was measured continuously throughout each test run for an average of 71 minutes each.
The average stable intraluminal pressure ranged from 25 mm Hg for 29.5-G perforation to 15 mm Hg for 23-G perforation. The lowest single pressure recorded ranged from 3 mm Hg for 23-G perforations to 17 mm Hg for 29.5-G perforations. Pressures of less than 15 mm Hg were recorded in more than 60% of the 23-G and 25-G perforations, less than 20% of the 27-G perforations, and none of the 29.5-G perforations.
At a flow rate of 2 microL/min of balanced salt solution, 23-G and 25-G needle perforations of silicone glaucoma drainage device tubes produce intraluminal pressures in vitro, which may result in low intraocular pressures. Immediate postoperative hypotony risk can be reduced if a smaller needle perforation is used.
研究近端莫尔顿引流管的针刺穿孔对恒流系统管腔内压力的影响。
通过连接测压储液器、压力传感器和闭塞的近端莫尔顿青光眼引流装置管的非扩张性硅管，以2微升/分钟的速率输注平衡盐溶液。当管腔内压力升至约30毫米汞柱时，用23G至29.5G尺寸的针头（一次性胰岛素注射器）对引流管穿孔一次。在每次测试过程中持续测量管腔内压力，每次平均测量71分钟。
平均稳定管腔内压力范围为，29.5G穿孔时为25毫米汞柱，23G穿孔时为15毫米汞柱。记录到的最低单次压力范围为，23G穿孔时为3毫米汞柱，29.5G穿孔时为17毫米汞柱。在23G和25G穿孔中，超过60%记录到的压力低于15毫米汞柱；27G穿孔中，低于20%记录到的压力低于15毫米汞柱；29.5G穿孔中，未记录到压力低于15毫米汞柱的情况。
以2微升/分钟的速率输注平衡盐溶液时，硅酮青光眼引流装置管的23G和25G针刺穿孔在体外产生的管腔内压力，可能导致低眼压。如果使用较小的针刺穿孔，可降低术后立即发生低眼压的风险。
