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Ahmed青光眼引流阀植入术治疗新生血管性青光眼的临床疗效分析及影响因素:一篇遵循STROBE规范的文章

Clinical efficacy analysis of Ahmed glaucoma valve implantation in neovascular glaucoma and influencing factors: A STROBE-compliant article.

作者信息

He Ye, Tian Ying, Song Weitao, Su Ting, Jiang Haibo, Xia Xiaobo

机构信息

Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College of Xiamen University, Xiamen, Fujian, China.

出版信息

Medicine (Baltimore). 2017 Oct;96(42):e8350. doi: 10.1097/MD.0000000000008350.

Abstract

This study aimed to evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation in treating neovascular glaucoma (NVG) and to analyze the factors influencing the surgical success rate.This is a retrospective review of 40 eyes of 40 NVG patients who underwent AGV implantation at Xiangya Hospital of Central South University, China, between January 2014 and December 2016. Pre- and postoperative intraocular pressure (IOP), visual acuity, surgical success rate, medications, and complications were observed. Surgical success criteria were defined as IOP ≤21 and >6 mm Hg with or without additional medications. Kaplan-Meier survival curves and Multivariate cox regression analysis were used to examine success rates and risk factors for surgical outcomes.The mean follow-up period was 8.88 ± 3.12 months (range: 3-17). IOP declined at each visit postoperatively and it was statistically significant (P < .001). An average of 3.55 ± 0.86 drugs was applied preoperatively, while an average of 0.64 ± 0.90 drugs was used postoperatively, with the difference being of statistical significance (P < .05). The complete surgical success rate of 3, 6, and 12 months after the operation was 85%, 75%, and 65%, respectively. Meanwhile, the qualified success rate of 3, 6, and 12 months after the operation was 85%, 80%, and 77.5%, respectively. The multivariate cox regression analysis showed that age (hazard ratio: 3.717, 7.246; 95% confidence interval: 1.149-12.048, 1.349-38.461; P = .028, .021) was influencing factors for complete success rate and qualified success rate among all NVG patients. Gender, previous operation history, primary disease, and preoperative IOP were found to be not significant.AGV implantation is an effective and safe surgical method to treat NVG. Age is an important factor influencing the surgical success rate.

摘要

本研究旨在评估艾哈迈德青光眼引流阀(AGV)植入术治疗新生血管性青光眼(NVG)的疗效,并分析影响手术成功率的因素。这是一项对2014年1月至2016年12月期间在中国中南大学湘雅医院接受AGV植入术的40例NVG患者的40只眼进行的回顾性研究。观察术前和术后的眼压(IOP)、视力、手术成功率、用药情况及并发症。手术成功标准定义为眼压≤21 mmHg且降低>6 mmHg,无论是否使用其他药物。采用Kaplan-Meier生存曲线和多变量cox回归分析来检验手术成功率和手术结果的危险因素。平均随访时间为8.88±3.12个月(范围:3 - 17个月)。术后每次随访眼压均下降,差异有统计学意义(P <.001)。术前平均使用3.55±0.86种药物,术后平均使用0.64±0.90种药物,差异有统计学意义(P <.05)。术后3个月、6个月和12个月的完全手术成功率分别为85%、75%和65%。同时,术后3个月、6个月和12个月的合格成功率分别为85%、80%和77.5%。多变量cox回归分析显示,年龄(风险比:3.717,7.246;95%置信区间:1.149 - 12.048,1.349 - 38.461;P = 0.028,0.021)是所有NVG患者完全成功率和合格成功率的影响因素。性别、既往手术史、原发疾病和术前眼压无统计学意义。AGV植入术是治疗NVG的一种有效且安全的手术方法。年龄是影响手术成功率的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c92/5662419/e53b8e1f910a/medi-96-e8350-g004.jpg

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