Wu Jun-shu, Zhuo Ye-hong, Li Yi-qing, Lin Ming-kai, Chai Fang, Ge Jian
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Yan Ke Za Zhi. 2009 Oct;45(10):879-82.
To evaluate the efficacy of surgical treatment for encapsulated cystic blebs around the plate after Ahmed glaucoma valve implantation.
This was a retrospective observational case series. Thirteen cases with elevated intraocular pressure (IOP) induced by fibrous proliferation around Ahmed valve were retrospectively studied. The intraocular pressure increased at 3 weeks to 5 months post-operation (2 months in average). The plates and tubes of Ahmed valve were in good position. No obstruction was seen in the tubes. Localized, encapsulated, cystic blebs were found in the equator of eyeball in which the plates were located. All cases underwent encapsulated cysts resection combined with mitomycin-C usage under conjunctival flaps. The excised tissues were sent for pathological examination. The changes of IOP and the outcome of the diseases were observed.
IOP was normal one month after surgery in all cases. The success rate was 100%. In the 3 - 20 months follow-up period, the IOP level kept normal in 3 cases without any anti-glaucoma medications. The IOP level was in normal range in 6 cases using two or three different kinds of anti-glaucoma medications. Three cases needed further surgical treatment because of uncontrolled IOP even with anti-glaucoma medications. Among them, the complete success rate was 75% (3/4) in patients more than 57 years old, while the complete success rate was 0 (0/8) in patients less than 37 years old.
It was considered an effective method of surgical treatment for encapsulated blebs around Ahmed glaucoma valve. The result was better in elderly patients than in younger patients relatively.
评估 Ahmed 青光眼引流阀植入术后巩膜瓣周围包裹性囊样水泡的手术治疗效果。
这是一项回顾性观察病例系列研究。回顾性研究 13 例因 Ahmed 引流阀周围纤维组织增生导致眼压升高的病例。眼压在术后 3 周 至 5 个月升高（平均 2 个月）。Ahmed 引流阀的巩膜瓣和引流管位置良好。引流管未见阻塞。在放置巩膜瓣的眼球赤道部发现局限性、包裹性、囊样水泡。所有病例均在结膜瓣下进行包裹性囊肿切除术并联合使用丝裂霉素 C。切除的组织送病理检查。观察眼压变化及疾病转归。
所有病例术后 1 个月眼压均正常。成功率为 100%。在 3 至 20 个月的随访期内，3 例未使用任何抗青光眼药物眼压水平保持正常。6 例使用两种或三种不同抗青光眼药物眼压水平在正常范围。3 例即使使用抗青光眼药物眼压仍控制不佳需进一步手术治疗。其中，57 岁以上患者完全成功率为 75%（3/4），37 岁以下患者完全成功率为 0（0/8）。
对于 Ahmed 青光眼引流阀周围包裹性水泡，手术治疗是一种有效的方法。相对而言，老年患者效果优于年轻患者。
