Faculty of Medicine, Cairo University, Cairo, Egypt.
Eye (Lond). 2013 Jun;27(6):728-34. doi: 10.1038/eye.2013.51. Epub 2013 Apr 12.
To compare the results of silicone and polypropylene Ahmed glaucoma valves (AGV) implanted during the first 10 years of life.
A prospective study was performed on 50 eyes of 33 patients with paediatric glaucoma. Eyes were matched to either polypropylene or silicone AGV. In eyes with bilateral glaucoma, one eye was implanted with polypropylene and the other eye was implanted with silicone AGV.
Fifty eyes of 33 children were reviewed. Twenty five eyes received a polypropylene valve, and 25 eyes received a silicone valve. Eyes implanted with silicone valves achieved a significantly lower intraocular pressure (IOP) compared with the polypropylene group at 6 months, 1 year, and 2 years postoperatively. The average survival time was significantly longer (P=0.001 by the log-rank test) for the silicone group than for the polypropylene group and the cumulative probability of survival by the log-rank test at the end of the second year was 80% (SE: 8.0, 95% confidence interval (CI): 64-96%) in the silicone group and 56% (SE: 9.8, 95% CI: 40-90%) in the polypropylene group. The difference in the number of postoperative interventions and complications between both groups was statistically insignificant.
Silicone AGVs can achieve better IOP control, and longer survival with less antiglaucoma drops compared with polypropylene valves in children younger than 10 years.
比较儿童期前 10 年植入的硅胶和聚丙烯 Ahmed 青光眼引流阀（AGV）的结果。
对 33 例儿童青光眼患者的 50 只眼进行了前瞻性研究。将眼与聚丙烯或硅胶 AGV 匹配。在双眼青光眼患者中，一只眼植入聚丙烯，另一只眼植入硅胶 AGV。
回顾了 33 名儿童的 50 只眼。25 只眼植入了聚丙烯阀，25 只眼植入了硅胶阀。植入硅胶阀的眼在术后 6 个月、1 年和 2 年时眼压（IOP）显著低于聚丙烯组。硅胶组的平均存活时间明显长于聚丙烯组（log-rank 检验 P=0.001），log-rank 检验在第 2 年末的累积存活率为硅胶组 80%（SE：8.0，95%置信区间（CI）：64-96%），聚丙烯组为 56%（SE：9.8，95% CI：40-90%）。两组术后干预和并发症的数量差异无统计学意义。
硅胶 AGV 可在 10 岁以下儿童中实现更好的眼压控制，与聚丙烯阀相比，生存时间更长，抗青光眼药物滴注次数更少。
