小儿患者的贝尔维尔德青光眼植入物
Baerveldt glaucoma implant in paediatric patients.
作者信息
van Overdam K A, de Faber J T H N, Lemij H G, de Waard P W T
机构信息
The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, Netherlands.
出版信息
Br J Ophthalmol. 2006 Mar;90(3):328-32. doi: 10.1136/bjo.2005.078832.
AIM
To evaluate the Baerveldt glaucoma implant (BGI) in paediatric glaucoma treatment.
METHODS
In a retrospective non-comparative case series 55 eyes of 40 consecutive paediatric patients (< or =16 years) with primary or secondary glaucoma underwent Baerveldt (350 mm2) implantation. Surgical outcome was evaluated by Kaplan-Meier table analysis.
RESULTS
The overall success rate was 80% at last follow up, with a mean follow up of 32 (range 2-78) months. Cumulative success was 94% at 12 months and 24 months, 85% at 36 months, 78% at 48 months, and 44% at 60 months. 11 eyes (20%) failed postoperatively because of an IOP >21 mm Hg (eight eyes), persistent hypotony (two eyes), and choroidal haemorrhage following cataract surgery (one eye). The most frequent complication needing surgery was tube related (20%). A new observation was mild to moderate dyscoria in 22% of the eyes, all buphthalmic, caused by entrapment of a tuft of peripheral iris in the tube track.
CONCLUSIONS
The BGI is effective and safe in the management of primary and secondary glaucoma. When angle surgery has proved to be unsuccessful or inappropriate in paediatric patients, a BGI is a good treatment option. One must be prepared to deal with the tube related problems.
目的
评估Baerveldt青光眼植入物（BGI）在小儿青光眼治疗中的效果。
方法
在一项回顾性非对照病例系列研究中，40例连续的小儿患者（年龄≤16岁）的55只眼睛，患有原发性或继发性青光眼，接受了Baerveldt（350平方毫米）植入术。通过Kaplan-Meier表格分析评估手术结果。
结果
末次随访时总体成功率为80%，平均随访时间为32个月（范围2 - 78个月）。12个月和24个月时累积成功率为94%，36个月时为85%，48个月时为78%，60个月时为44%。11只眼睛（20%）术后失败，原因是眼压>21毫米汞柱（8只眼睛）、持续性低眼压（2只眼睛）以及白内障手术后脉络膜出血（1只眼睛）。最常见的需要手术处理的并发症与引流管相关（20%）。一项新的观察结果是，22%的眼睛出现轻度至中度瞳孔变形，均为牛眼，是由于一束周边虹膜被困在引流管通道所致。
结论
BGI在原发性和继发性青光眼的治疗中有效且安全。当在小儿患者中房角手术已被证明不成功或不适用时，BGI是一种很好的治疗选择。必须做好处理与引流管相关问题的准备。
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