El-Saied Heba M A, Adullatif Abdussalam M
Department of Ophthalmology, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
J Glaucoma. 2017 Jun;26(6):e190-e193. doi: 10.1097/IJG.0000000000000657.
The aim of this study was to assess the value of intravitreal injection of nonexpansile C3F8 12% in the prevention of suprachoroidal hemorrhage (SCH) after Ahmed valve implantation for the treatment of secondary glaucoma in vitrectomized, aphakic, and aniridic eyes following blunt trauma.
This is a case series of 5 patients who presented with traumatic secondary glaucoma in vitrectomized, aphakic, and aniridic eyes. Vitrectomy was performed in all eyes after trauma for the treatment of the vitreous hemorrhage. Ahmed valve implantation with complete filling of the vitreous cavity with nonexpansile C3F8 was carried out 2±0.2 months after vitrectomy. The outcome measures were evaluating the value of intraoperative filling of the vitreous cavity with gas in preventing SCH after Ahmed valve implantation and the ability of Ahmed valve implantation to control the intraocular pressure (IOP) in vitrectomized, aphakic, and aniridic eyes. All patients were examined up to 6 months.
Inspite of the multiple risk factors present in our patients in the form of aphakia, vitrectomized eyes, and aniridia, no patient developed postoperative hypotony or SCH during the postoperative period. The gas was absorbed over 2 months and the IOP was maintained during the early postoperative period. Mean postoperative IOP was 15.2±1.09, 12.2±1.09, 18.4±7.12, 15.2±2.28, and 14.8±1. 09 mm Hg at 1 day, 1 week, 1 month, 3 months, and 6 months, respectively. The final postoperative best-corrected visual acuity was 0.66±0.13.
Complete filling of the vitreous cavity with nonexpansile gas can prevent postoperative SCH after Ahmed valve implantation in the treatment of secondary glaucoma in vitrectomized, aphakic, and aniridic eyes.
本研究旨在评估玻璃体腔内注射12%非膨胀性C3F8在预防钝挫伤后行玻璃体切割术、无晶状体眼和无虹膜眼继发青光眼患者行Ahmed人工瓣膜植入术后脉络膜上腔出血（SCH）中的价值。
这是一个包含5例玻璃体切割术、无晶状体眼和无虹膜眼外伤性继发青光眼患者的病例系列。所有患者外伤后均行玻璃体切割术治疗玻璃体积血。玻璃体切割术后2±0.2个月行Ahmed人工瓣膜植入术，术中玻璃体腔用非膨胀性C3F8完全填充。观察指标为评估玻璃体腔气体填充在预防Ahmed人工瓣膜植入术后SCH中的价值，以及Ahmed人工瓣膜植入术在玻璃体切割术、无晶状体眼和无虹膜眼中控制眼压（IOP）的能力。所有患者均接受长达6个月的检查。
尽管我们的患者存在无晶状体、玻璃体切割术后眼和无虹膜等多种危险因素，但术后无患者发生低眼压或SCH。气体在2个月内吸收，术后早期眼压维持稳定。术后1天、1周、1个月、3个月和6个月时，平均眼压分别为15.2±1.09、12.2±1.09、18.4±7.12、15.2±2.28和14.8±1.09 mmHg。术后最终最佳矫正视力为0.66±0.13。
玻璃体腔用非膨胀性气体完全填充可预防Ahmed人工瓣膜植入术治疗玻璃体切割术、无晶状体眼和无虹膜眼继发青光眼后的术后SCH。
