Satana Banu, Yalvac Ilgaz S, Sungur Gulten, Eksioglu Umit, Basarir Berna, Altan Cigdem, Duman Sunay
*Beyoglu Eye Research and Training Hospital †Yeditepe University Medical School, Eye Clinic, Istanbul ‡Ankara Training and Research Hospital, Eye Clinic, Ankara, Turkey.
J Glaucoma. 2015 Oct-Nov;24(8):607-12. doi: 10.1097/IJG.0000000000000062.
To evaluate outcomes of patients with uveitic glaucoma secondary to Behçet disease (BD) who underwent Ahmed glaucoma valve (AGV) implantation.
A retrospective chart review of 14 eyes of 10 patients with uveitic glaucoma associated with BD who underwent AGV implantation at a tertiary referral center. Treatment success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg with or without antiglaucoma medication, without further additional glaucoma surgery or loss of light perception. The main outcome measures were IOP, best-corrected visual acuity measured with Snellen charts, and number of glaucoma medications.
Mean duration of postoperative follow-up was 18.2±6.6 months (range, 6 to 31 mo). Of the 14 eyes, 10 (71.4%) were pseudophakic and 5 (35.7%) had primary AGV implantation without a history of previous glaucoma surgery. At the most recent follow-up visit, 13 of the 14 eyes had an IOP between 6 and 21 mm Hg. Mean IOP was significantly reduced during follow-up, as compared with preoperative values (P≤0.005). The cumulative probability of surgical success rate was 90.9% at 18 months based on Kaplan-Meier survival analysis. The mean number of antiglaucoma medications required to achieve the desired IOP decreased from 3.4±0.5 preoperatively to 1.0±1.1 postoperatively (P≤0.05). Visual acuity loss of >2 lines occurred in 4 eyes (28.5%) due to optic atrophy associated with retinal vasculitis. Temporary hypotony developed during follow-up in 4 eyes (28.5%) at first postoperative week.
For the management of uveitic glaucoma associated with BD, AGV implantation is a successful method for glaucoma control but requires additional surgical interventions for high early hypotony rates.
评估继发于白塞病（BD）的葡萄膜炎性青光眼患者接受艾哈迈德青光眼引流阀（AGV）植入术的疗效。
对一家三级转诊中心10例患有与BD相关的葡萄膜炎性青光眼且接受了AGV植入术的患者的14只眼进行回顾性病历审查。治疗成功定义为眼压（IOP）在6至21 mmHg之间，无论是否使用抗青光眼药物，无需进一步的青光眼手术或无光感丧失。主要观察指标为眼压、用斯内伦视力表测量的最佳矫正视力以及抗青光眼药物的数量。
术后平均随访时间为18.2±6.6个月（范围6至31个月）。14只眼中，10只（71.4%）为人工晶状体眼，5只（35.7%）首次植入AGV且无既往青光眼手术史。在最近一次随访时，14只眼中有13只眼压在6至21 mmHg之间。与术前值相比，随访期间平均眼压显著降低（P≤0.005）。根据Kaplan-Meier生存分析，18个月时手术成功率的累积概率为90.9%。达到所需眼压所需的抗青光眼药物平均数量从术前的3.4±0.5降至术后的1.0±1.1（P≤0.05）。4只眼（28.5%）因与视网膜血管炎相关的视神经萎缩导致视力下降超过2行。4只眼（28.5%）在术后第一周随访期间出现暂时性低眼压。
对于BD相关的葡萄膜炎性青光眼的治疗，AGV植入术是控制青光眼的一种成功方法，但因早期低眼压发生率高，需要额外的手术干预。
