Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.
Am J Ophthalmol. 2013 Mar;155(3):530-5. doi: 10.1016/j.ajo.2012.09.001. Epub 2012 Dec 4.
To assess the effect of Ahmed glaucoma valve implants on corneal endothelial cell density (ECD) in children with uveitic glaucoma.
Cross-sectional study.
setting: Institutional. patientpopulation: Eighty eyes from 42 patients diagnosed with uveitis before the age of 16. Twenty-eight eyes had an Ahmed glaucoma valve implant because of secondary glaucoma. Fifty-two eyes without an implant served as controls. intervention orobservationprocedure(s): Corneal ECD was examined cross-sectionally using a noncontact specular microscope. Univariate and multivariate generalized estimating equations analyses with correction for paired eyes were performed. mainoutcomemeasure(s): Correlation of ECD with the presence of an Ahmed glaucoma valve implant and with the time following implantation.
ECD was significantly lower in the Ahmed glaucoma valve group than in controls (2359 and 3088 cells/mm(2), respectively; P < .001) following an average of 3.5 years after Ahmed glaucoma valve implantation. Presence of an Ahmed glaucoma valve implant, previous intraocular surgery, age, duration of uveitis, and history of corneal touch by the implant tube were all significantly associated with decreased ECD. Following a multivariate analysis, presence of an Ahmed glaucoma valve implant (B = -340; adjusted P < .011) and older age (B = -58; adjusted P = .005) remained independently associated with decreased ECD. Within the implant group, the age-adjusted time interval following Ahmed glaucoma valve implantation was highly correlated with decreased ECD (B = -558, P < .001).
Ahmed glaucoma valve implants in children with uveitic glaucoma are independently associated with decreased ECD, and this effect is associated with the time interval following Ahmed glaucoma valve implantation.
评估 Ahmed 青光眼引流阀植入术对儿童葡萄膜炎性青光眼患者角膜内皮细胞密度（ECD）的影响。
横断面研究。
研究场所：院内。患者人群：42 名 16 岁以下被诊断为葡萄膜炎的患者的 80 只眼。其中 28 只眼因继发青光眼而植入 Ahmed 青光眼引流阀，52 只眼未植入该引流阀作为对照。干预或观察措施：使用非接触式共焦显微镜对角膜 ECD 进行横断面检查。采用单变量和多变量广义估计方程分析，并对配对眼进行校正。主要观察指标：ECD 与 Ahmed 青光眼引流阀植入的存在以及植入后时间的相关性。
在植入 Ahmed 青光眼引流阀后平均 3.5 年，Ahmed 青光眼引流阀组的 ECD 明显低于对照组（分别为 2359 和 3088 个细胞/mm2；P<0.001）。植入 Ahmed 青光眼引流阀、既往眼内手术、年龄、葡萄膜炎持续时间和植入管接触角膜史均与 ECD 降低显著相关。经过多变量分析，植入 Ahmed 青光眼引流阀（B=-340；校正 P<0.011）和年龄较大（B=-58；校正 P=0.005）与 ECD 降低仍独立相关。在植入组内，年龄校正的 Ahmed 青光眼引流阀植入后时间间隔与 ECD 降低高度相关（B=-558，P<0.001）。
儿童葡萄膜炎性青光眼患者植入 Ahmed 青光眼引流阀与 ECD 降低独立相关，这种效应与 Ahmed 青光眼引流阀植入后时间间隔相关。
