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艾哈迈德青光眼引流阀植入治疗葡萄膜炎性青光眼的长期疗效

Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma.

作者信息

Papadaki Thekla G, Zacharopoulos Ioannis P, Pasquale Louis R, Christen William B, Netland Peter A, Foster C Stephen

机构信息

Massachusetts Eye Research and Surgery Institute, Ocular Immunology and Uveitis Foundation, Harvard Medical School Boston, Massachusetts, USA.

出版信息

Am J Ophthalmol. 2007 Jul;144(1):62-69. doi: 10.1016/j.ajo.2007.03.013. Epub 2007 May 9.

Abstract

PURPOSE

To present long-term outcomes of Ahmed glaucoma valve implantation for uveitic glaucoma.

DESIGN

Interventional case series.

METHODS

Retrospective chart review of 60 patients (60 eyes) with uveitic glaucoma who underwent Ahmed valve implantation over a four-year period at a tertiary uveitis referral center. Success definition 1 included patients with an intraocular pressure (IOP) between 5 and 21 mm Hg, reduced by 25% from that before implantation. Success definition 2 (qualified success) excluded those patients in whom serious complications occurred.

RESULTS

Mean follow-up time was 30 months (range, six to 87 months; four-year results relate to a cohort of 15 patients). Success rates were 77% and 50% and qualified success rates were 57% and 39% at one and four years, respectively. At four years, 74% of the patients required glaucoma medication to maintain IOP control. The overall complication rate was 12%/person-years. The rate of visual acuity loss was 4%/person-years; that was most commonly attributed to corneal complications that were more likely to occur in patients with preoperative corneal disease (P = .01, Fisher exact test).

CONCLUSIONS

Ahmed glaucoma valve implantation is a safe yet moderately successful procedure for uveitic glaucoma. Long-term success rates are enhanced with the use of glaucoma medications, and corneal complications are the most common of all potential serious complications.

摘要

目的

介绍Ahmed青光眼引流阀植入术治疗葡萄膜炎性青光眼的长期疗效。

设计

介入性病例系列研究。

方法

回顾性分析一家三级葡萄膜炎转诊中心在四年期间对60例(60只眼)葡萄膜炎性青光眼患者行Ahmed引流阀植入术的病历资料。成功定义1包括眼压(IOP)在5至21 mmHg之间且较植入前降低25%的患者。成功定义2(合格成功)排除发生严重并发症的患者。

结果

平均随访时间为30个月(范围为6至87个月;四年结果涉及15例患者队列)。1年和4年时的成功率分别为77%和50%,合格成功率分别为57%和39%。4年时,74%的患者需要使用青光眼药物来维持眼压控制。总体并发症发生率为12%/人年。视力丧失率为4%/人年;最常见的原因是角膜并发症,术前有角膜疾病的患者更易发生(P = 0.01,Fisher精确检验)。

结论

Ahmed青光眼引流阀植入术治疗葡萄膜炎性青光眼是一种安全但成功率中等的手术。使用青光眼药物可提高长期成功率,角膜并发症是所有潜在严重并发症中最常见的。

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