Ceballos Elizenda M, Parrish Richard K, Schiffman Joyce C
Department of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, Miami, Florida, USA.
Ophthalmology. 2002 Dec;109(12):2256-60. doi: 10.1016/s0161-6420(02)01294-0.
To evaluate the efficacy and safety of Baerveldt glaucoma drainage devices in the management of uveitic glaucoma.
Retrospective, noncomparative case series.
Twenty-four eyes of 24 patients who underwent implantation of Baerveldt glaucoma drainage devices between 1996 and 2000 for the treatment of uveitic glaucoma refractory to medical therapy.
Implantation of Baerveldt glaucoma drainage device.
Control of intraocular pressure (IOP), number of glaucoma medications needed for adequate IOP control, visual acuity, complications associated with the surgery, and the effect of subsequent surgery on the ability of the device to control IOP. Success was defined as IOP >/=5 and </=21 mmHg with or without antiglaucoma medications and without need for further glaucoma surgery, loss of light perception, or phthisis.
Cumulative life-table success rates were 95.8% at 3 months and 91.7% at 6 months, 12 months, and 24 months. The mean postoperative follow-up was 20.8 months. The IOP was reduced from a preoperative mean of 30.5 +/- 8.96 mmHg with 3.1 +/- 0.99 antiglaucoma medications to a postoperative mean at 6 months or 1 year of 13.0 +/- 4.6 mmHg (P < 0.001) with 0.8 +/- 0.8 antiglaucoma medications (P < 0.001). At last follow-up 14 of 24 eyes (58.3%) required no antiglaucoma medications. Best-corrected visual acuity improved or remained within 2 lines of preoperative visual acuity in 19 (79.2%) eyes. The most common complications were choroidal effusions in four (16.7%), hypotony in three (12.5%) eyes, cystoid macular edema in three (12.5%) eyes, and failure of corneal grafts in two (8.3%). Seven of 22 eyes (31.8%) in which successful control of IOP with the Baerveldt implant was achieved underwent subsequent nonglaucoma-related incisional surgery. None of these eyes (0%) lost IOP control after the subsequent procedure.
The Baerveldt glaucoma drainage device offers reasonable safety and effectiveness for the control of IOP in eyes with uveitis and refractory glaucoma.
评估Baerveldt青光眼引流装置治疗葡萄膜炎性青光眼的疗效和安全性。
回顾性、非对照病例系列研究。
1996年至2000年间接受Baerveldt青光眼引流装置植入术治疗药物治疗无效的葡萄膜炎性青光眼的24例患者的24只眼。
植入Baerveldt青光眼引流装置。
眼压控制情况、眼压得到充分控制所需的青光眼药物数量、视力、手术相关并发症以及后续手术对装置眼压控制能力的影响。成功定义为眼压在使用或不使用抗青光眼药物的情况下≥5mmHg且≤21mmHg，且无需进一步的青光眼手术、无光感或眼球萎缩。
3个月时累积生命表成功率为95.8%，6个月、12个月和24个月时为91.7%。术后平均随访时间为20.8个月。眼压从术前平均30.5±8.96mmHg（使用3.1±0.99种抗青光眼药物）降至术后6个月或1年时的平均13.0±4.6mmHg（P<0.001），使用0.8±0.8种抗青光眼药物（P<0.001）。在最后一次随访时，24只眼中有14只（58.3%）无需使用抗青光眼药物。19只（79.2%）眼的最佳矫正视力提高或保持在术前视力的2行以内。最常见的并发症是4只眼（16.7%）出现脉络膜渗漏，3只眼（12.5%）出现低眼压，3只眼（12.5%）出现黄斑囊样水肿，2只眼（8.3%）出现角膜移植失败。在22只使用Baerveldt植入物成功控制眼压的眼中，有7只（31.8%）接受了后续的非青光眼相关切开手术。这些眼中无一例（0%）在后续手术中失去眼压控制。
Baerveldt青光眼引流装置在控制葡萄膜炎性难治性青光眼患者的眼压方面具有合理的安全性和有效性。
