Cullen Cheryl L
Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada, C1A 4P3.
Vet Ophthalmol. 2004 Sep-Oct;7(5):311-8. doi: 10.1111/j.1463-5224.2004.00320.x.
To evaluate the efficacy of a novel, professionally manufactured, frontal sinus valved glaucoma shunt in maintaining normal intraocular pressure (IOP) and vision in dogs with primary glaucoma.
Three eyes of three dogs diagnosed with primary glaucoma were included in this prospective clinical study. A Cullen frontal sinus valved glaucoma shunt was implanted into each glaucomatous globe. Dogs were treated postoperatively with topical neomycin/polymyxin B/0.1% dexamethasone and 0.03% flurbiprofen every 6 h tapered over 8-12 weeks, and meloxicam at 0.1 mg/kg orally every 24 h for 7-10 days. IOP, intracameral shunt position and apparent patency, and vision were assessed twice daily for up to 4 (n= 3 eyes) and 10 (n= 2 eyes) days postoperatively, and then at re-examination periods of up to 36 weeks (n= 1 eye). Postoperative complications were recorded and documented photographically.
Normal IOP was maintained in all shunted globes (range 10-29 mmHg; mean = 16.7 mmHg at 24 h; IOP = 23 mmHg at 36 weeks) postoperatively for 2 days (3/3 eyes), 8 weeks (2/2 eyes), and 36 weeks (1/1 eye) without additional antiglaucoma therapies. Photopic vision and shunt position and patency were maintained in all shunted globes for all follow-up periods. Postoperative complications included mild aqueous flare and fibrin (n= 3 eyes for 3-10 days postoperatively); intracameral shunt occlusion with fibrin (n= 1 eye at days 2 and 4); partial anterior chamber tube extrusion (n= 1 eye at day 4), and focal corneal edema (n= 1 eye at 18 weeks). Tissue plasminogen activator injected intracamerally through the silicone tube near the frontal sinus effectively resolved the fibrinous shunt occlusion.
The Cullen frontal sinus valved glaucoma shunt shows promise for the management of canine primary glaucoma.
评估一种新型的、专业制造的额窦带瓣青光眼分流管在维持原发性青光眼犬眼正常眼压（IOP）和视力方面的疗效。
本前瞻性临床研究纳入了3只被诊断为原发性青光眼的犬的3只眼睛。将卡伦额窦带瓣青光眼分流管植入每只青光眼眼球。术后每6小时给犬局部应用新霉素/多粘菌素B/0.1%地塞米松和0.03%氟比洛芬，持续8 - 12周逐渐减量，口服美洛昔康0.1 mg/kg，每日1次，共7 - 10天。术后每天评估眼压、前房内分流管位置和通畅情况以及视力，最长评估4天（n = 3只眼）和10天（n = 2只眼），然后在长达36周的复查期（n = 1只眼）进行评估。记录术后并发症并拍照记录。
所有植入分流管的眼球术后在无需额外抗青光眼治疗的情况下，眼压在2天（3/3只眼）、8周（2/2只眼）和36周（1/1只眼）维持正常（范围为(10 - 29 mmHg)；24小时时平均为(16.7 mmHg)；36周时眼压为(23 mmHg)）。在所有随访期内，所有植入分流管的眼球的明视觉、分流管位置和通畅情况均得以维持。术后并发症包括轻度房水闪光和纤维蛋白形成（术后3 - 10天，3只眼）；前房内分流管被纤维蛋白阻塞（第2天和第4天，1只眼）；部分前房引流管挤出（第4天，1只眼），以及局限性角膜水肿（第18周，1只眼）。通过额窦附近的硅胶管向眼内注射组织纤溶酶原激活剂有效地解决了纤维蛋白性分流管阻塞问题。
卡伦额窦带瓣青光眼分流管在犬原发性青光眼的治疗中显示出前景。
