Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
J Glaucoma. 2010 Dec;19(9):581-6. doi: 10.1097/IJG.0b013e3181ca7f7f.
To evaluate the results of Ahmed Glaucoma Valve surgery in neovascular glaucoma and control patients.
In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, without further glaucoma surgery, and without loss of light perception.
Average follow-up for control and neovascular glaucoma patients was 18.4 and 17.4 months, respectively (P=0.550). The mean IOPs were 17.9±8.4 mm Hg and 16.5±15.8 mm Hg at 1-year (P=0.150), and 18.4±11.2 mm Hg and 9.9±6.3 mm Hg at 2 years (P=0.057) in controls and eyes with neovascular glaucoma, respectively. Life-table analysis showed a significantly lower success for neovascular glaucoma patients compared with controls (P=0.0096), with success at 1 year=89.2% and 73.1%, 2 years=81.8% and 61.9%, and 5 years=81.8% and 20.6% for control and neovascular glaucoma eyes, respectively. Cox proportional hazard regression analysis showed neovascular glaucoma as a risk factor for surgical failure (odds ratio=5.384, 95% CI=1.22-23.84, P=0.027). Although IOP control and complications were comparable between the 2 groups, visual outcomes were worse in neovascular glaucoma patients, with 9 (23.7%) eyes with neovascular glaucoma compared with no controls losing light perception vision (P=0.002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period.
Neovascular glaucoma patients have greater risk of surgical failure after Ahmed Glaucoma Valve surgery compared with controls. Despite improved IOP with drainage implants, visual outcomes may be poor, probably owing to progression of underlying disease.
评估 Ahmed 青光眼引流阀手术治疗新生血管性青光眼和对照患者的结果。
在这项回顾性对照研究中，我们比较了对照患者（N=38）和匹配的新生血管性青光眼患者（N=38）的手术结果。成功定义为眼内压（IOP）≥6mmHg 且≤21mmHg，无需进一步青光眼手术，且不丧失光感。
对照患者和新生血管性青光眼患者的平均随访时间分别为 18.4 个月和 17.4 个月（P=0.550）。在 1 年时，对照组和新生血管性青光眼组的平均 IOP 分别为 17.9±8.4mmHg 和 16.5±15.8mmHg（P=0.150），在 2 年时，分别为 18.4±11.2mmHg 和 9.9±6.3mmHg（P=0.057）。寿命表分析显示，新生血管性青光眼患者的成功率明显低于对照组（P=0.0096），1 年时的成功率分别为 89.2%和 73.1%，2 年时的成功率分别为 81.8%和 61.9%，5 年时的成功率分别为 81.8%和 20.6%。Cox 比例风险回归分析显示，新生血管性青光眼是手术失败的危险因素（比值比=5.384，95%CI=1.22-23.84，P=0.027）。尽管两组的眼压控制和并发症相当，但新生血管性青光眼患者的视力结果更差，有 9（23.7%）只眼的新生血管性青光眼患者失去光感视力，而对照组没有（P=0.002）。视力丧失（9 例中有 5 例）的大多数患者在术后期间成功控制了眼压。
与对照患者相比，新生血管性青光眼患者在 Ahmed 青光眼引流阀手术后发生手术失败的风险更高。尽管引流植入物改善了眼压，但视力结果可能较差，可能是由于潜在疾病的进展。
