Baig Nafees B, Lin Alice A, Freedman Sharon F
The Chinese University of Hong Kong and Hong Kong Eye Hospital, Hong Kong.
Raleigh Eye Center, Raleigh, North Carolina.
J AAPOS. 2015 Jun;19(3):281-4. doi: 10.1016/j.jaapos.2015.02.001. Epub 2015 Apr 21.
This study evaluated B-scan ultrasound as a technique for assessing glaucoma drainage device (GDD) patency/function in refractory pediatric glaucoma. We retrospectively evaluated 70 eyes of 52 patients after Ahmed (n = 40 eyes), Baerveldt (n = 27 eyes) and Molteno (n = 5 eyes) GDD implantation; 2 eyes each had 2 GDDs. Median age was 6.5 years. Glaucoma diagnoses included primary congenital glaucoma (n = 19) and secondary glaucoma associated with aphakia (n = 16), aniridia (n = 5), Peters anomaly (n = 3), uveitis (n = 2), and other conditions (n = 7). B-scan ultrasound evaluation proved helpful to clinical assessment when the GDD tube was not seen because of opaque corneas (n = 20 eyes), the bleb was not visualized (n = 21 eyes), or IOP was elevated (n = 28 eyes). Ultrasound findings suggesting a nonpatent or malfunctioning GDD were further confirmed by subsequent intraoperative bleb needling (n = 2 eyes) and GDD revision (n = 7 eyes). B-scan ultrasound evaluation can serve as a useful adjunct in evaluating GDD patency/function in selected eyes with refractory pediatric glaucoma and may aid in clinical management.
本研究评估了B超作为评估难治性儿童青光眼引流装置(GDD)通畅性/功能的一项技术。我们回顾性评估了52例患者的70只眼,这些患者接受了艾哈迈德(n = 40只眼)、贝尔维尔德(n = 27只眼)和莫尔滕诺(n = 5只眼)GDD植入术;2只眼各植入了2个GDD。中位年龄为6.5岁。青光眼诊断包括原发性先天性青光眼(n = 19)和与无晶状体相关的继发性青光眼(n = 16)、无虹膜(n = 5)、彼得斯异常(n = 3)、葡萄膜炎(n = 2)以及其他情况(n = 7)。当由于角膜混浊(n = 20只眼)而看不到GDD管、看不到滤过泡(n = 21只眼)或眼压升高(n = 28只眼)时,B超评估被证明有助于临床评估。后续术中滤过泡针刺(n = 2只眼)和GDD翻修(n = 7只眼)进一步证实了提示GDD不通畅或功能不良的超声检查结果。B超评估可作为评估难治性儿童青光眼特定眼GDD通畅性/功能的有用辅助手段,并可能有助于临床管理。