Graham Kathleen L, Donaldson David, Billson Francis A, Billson F Mark
Department of Ophthalmology and Eye Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Ophthalmology Department, Dick White Referrals, Cambridgeshire, UK.
Vet Ophthalmol. 2017 Sep;20(5):427-434. doi: 10.1111/vop.12443. Epub 2016 Nov 16.
To evaluate the 350-mm Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin-C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology.
Retrospective case series.
Twenty-eight client-owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma.
The medical records of all dogs undergoing placement of a 350-mm Baerveldt GDD at a veterinary ophthalmology referral service between 2013 and 2016 were reviewed. Signalment, diagnosis, duration and previous treatment of glaucoma, previous intraocular surgery, IOP, visual, and surgical outcomes were recorded.
IOP was maintained <20mmHg in 24 of 32 (75.0%) eyes. Fourteen eyes (43.8%) required no adjunctive treatments to maintain this IOP control. Fewer doses of glaucoma medication were required following surgery. Vision was retained in 18 of 27 (66.7%) eyes with vision at the time of surgery. No eyes that were blind at the time of surgery (n = 5) had restoration of functional vision. Complications following surgery included hypotony (26/32; 81.3%), intraocular hypertension (24/32; 75.0%), and fibrin formation within the anterior chamber (20/32; 62.5%). The average follow-up after placement of the GDD was 361.1 days (median 395.6 days).
Efforts to minimize postoperative hypotony and address the fibroproliferative response following placement of a 350-mm Baerveldt GDD showed an increased success rate to other reports of this device in dogs and offers an alternative surgical treatment for controlling intraocular pressure in dogs with glaucoma.
按照眼科领域报道的方法,对难治性青光眼犬应用350毫米Baerveldt青光眼引流装置(GDD),并进行改善术后低眼压的处理(腔外结扎;腔内支架)以及减轻纤维增殖反应(术中使用丝裂霉素C;术后口服秋水仙碱和泼尼松龙),评估该装置的效果。
回顾性病例系列研究。
28只客户拥有的犬(32只眼),其中包括7只(9只眼)原发性青光眼犬和21只(23只眼)继发性青光眼犬。
回顾2013年至2016年期间在一家兽医眼科转诊机构接受350毫米Baerveldt GDD植入手术的所有犬只的病历。记录品种、诊断、青光眼病程及既往治疗情况、既往眼内手术、眼压、视力和手术结果。
32只眼中有24只(75.0%)眼压维持在<20mmHg。14只眼(43.8%)无需辅助治疗即可维持眼压控制。术后所需青光眼药物剂量减少。手术时有视力的27只眼中有18只(66.7%)保留了视力。手术时失明的5只眼中没有恢复功能性视力的。术后并发症包括低眼压(26/32;81.3%)、高眼压(24/32;75.0%)和前房内纤维蛋白形成(20/32;62.5%)。GDD植入后的平均随访时间为361.1天(中位数395.6天)。
采取措施尽量减少术后低眼压并处理350毫米Baerveldt GDD植入后的纤维增殖反应,与该装置在犬中的其他报道相比成功率有所提高,为控制犬青光眼的眼压提供了一种替代性手术治疗方法。