Kirwan C, O'Keefe M, Lanigan B, Mahmood U
The Children's University Hospital, National Children's Eye CenterTemple Street, Dublin 1, Republic of Ireland.
Br J Ophthalmol. 2005 Jul;89(7):855-8. doi: 10.1136/bjo.2004.056143.
Paediatric aphakic glaucoma presents months or years after cataract surgery in children and is a major long term complication. The results of surgical treatment are poor and many children require multiple and repeat procedures with poor visual outcomes.
13 children (19 eyes) had Ahmed valve implantation surgery, nine of the children had previous procedures such as cycloablation or trabeculectomy. Mitomycin was used at surgery in some patients and valve needling with Healon GV and 5-fluorouracil in some blebs after surgery. SF(6) gas was also used at the time of surgery in most children to reform the anterior chamber.
12 of the children (18 eyes) achieved intraocular pressure control of 15 mm Hg or less with a valve alone or with additional medical therapy.
Ahmed valve implantation surgery alone or in combination with medical therapy is successful and safe in the management of paediatric aphakic glaucoma.
儿童无晶状体性青光眼在儿童白内障手术后数月或数年出现,是一种主要的长期并发症。手术治疗效果不佳,许多儿童需要多次重复手术,视力预后较差。
13名儿童(19只眼)接受了艾哈迈德瓣膜植入手术,其中9名儿童此前接受过如睫状体光凝或小梁切除术等手术。部分患者手术时使用了丝裂霉素,术后部分滤过泡使用透明质酸钠和5-氟尿嘧啶进行瓣膜针刺。大多数儿童手术时还使用了六氟化硫气体来重建前房。
12名儿童(18只眼)仅通过瓣膜或联合其他药物治疗实现了眼压控制在15mmHg或更低。
单独使用艾哈迈德瓣膜植入手术或联合药物治疗在儿童无晶状体性青光眼的治疗中是成功且安全的。