Every Sean G, Molteno Anthony C B, Bevin Tui H, Herbison Peter
Section of Ophthalmology, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Arch Ophthalmol. 2006 Mar;124(3):355-60. doi: 10.1001/archopht.124.3.355.
To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno implants.
A prospective study of 145 eyes (130 patients) followed up for a mean of 3.3 years (range, 0.02 year [5 days] to 18.1 years) in the province of Otago, New Zealand, from 1979 to 2002.
Insertion of a Molteno implant controlled the intraocular pressure at 21 mm Hg or less with a probability (95% confidence interval) of 0.72 (0.64-0.80), 0.60 (0.51-0.69), and 0.40 (0.29-0.50) at 1, 2, and 5 years, respectively. Failure to control intraocular pressure at 1, 2, and 5 years was significantly correlated with persistent iris neovascularization (P<.001, P<.001, and P = .01, respectively). Visual acuity at final follow-up in nonenucleated eyes was maintained or improved in 56 eyes (39%) and deteriorated to light perception or better in 25 (17%) or no light perception in 47 (32%). Seventeen eyes (12%) were enucleated.
The insertion of Molteno implants for neovascular glaucoma maintained or improved vision in 39% of eyes, whereas 12% were eventually enucleated (all of which initially had visual acuity <20/1200). The outcome depended mainly on progression of the underlying vascular disease.
描述采用莫尔顿引流物治疗新生血管性青光眼的长期疗效。
对1979年至2002年在新西兰奥塔哥省的145只眼（130例患者）进行前瞻性研究，平均随访3.3年（范围为0.02年[5天]至18.1年）。
植入莫尔顿引流物后，眼压控制在21mmHg或更低的概率（95%置信区间）在1年、2年和5年时分别为0.72（0.64 - 0.80）、0.60（0.51 - 0.69）和0.40（0.29 - 0.50）。1年、2年和5年时眼压控制不佳与持续性虹膜新生血管形成显著相关（分别为P<0.001、P<0.001和P = 0.01）。在未摘除眼球的眼中，末次随访时视力保持或提高的有56只眼（39%），视力恶化至光感或更好的有25只眼（17%），无光感的有47只眼（32%）。17只眼（12%）被摘除眼球。
对于新生血管性青光眼植入莫尔顿引流物，39%的患眼视力得以保持或提高，而最终有12%的患眼被摘除眼球（所有这些患眼最初视力均<20/1200）。疗效主要取决于潜在血管疾病的进展情况。
