一项关于阿迈德引流阀与阿迈德引流阀联合氟轻松植入物治疗葡萄膜炎性青光眼疗效的回顾性研究。

A retrospective study on the outcomes of Ahmed valve versus Ahmed valve combined with fluocinolone implant in uveitic glaucoma.

作者信息

Sevgi Duriye D, Davoudi Samaneh, Talcott Katherine E, Cho Heeyoon, Guo Rong, Lobo Ann-Marie, Papaliodis George N, Turalba Angela, Sobrin Lucia, Shen Lucy Q

机构信息

Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.

Koc University School of Medicine, Istanbul, Turkey.

出版信息

Digit J Ophthalmol. 2017 Sep 11;23(3):63-70. doi: 10.5693/djo.01.2017.06.001. eCollection 2017.

DOI:10.5693/djo.01.2017.06.001

PMID:29162989

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5683439/

Abstract

PURPOSE

To compare the intraocular pressure (IOP) outcomes of Ahmed glaucoma valve (AGV) surgery alone versus AGV with fluocinolone implant in uveitic glaucoma patients.

METHODS

We identified uveitic glaucoma patients with AGV surgery alone and AGV surgery combined with fluocinolone implant from the Massachusetts Eye and Ear Ocular Inflammation Database. Demographic information, visual acuity, and IOP were recorded at preoperative visits and 1, 6, and 12 months after surgery. Incidence of hypertensive phase, defined as an IOP of >21 mm Hg or use of additional treatment to lower IOP occurring any time between 7 days to 6 months postoperatively, was investigated. Multilevel mixed effects models were performed to compare the outcomes between groups.

RESULTS

Eighteen eyes of 13 uveitic glaucoma patients with 1-year follow-up data were included. There were 11 eyes of 9 patients (mean age, 56.5 years; 63.6% male) in the AGV group and 7 eyes of 4 patients (mean age, 61.3 years; 71.4% male) in the AGV + fluocinolone group. There was no significant difference in visual acuity change at 1 year after surgery between groups ( = 0.25), although visual acuity improvement was significant in the AGV group ( = 0.01). The hypertensive phase occurred in 91% of AGV patients and 43% of AGV + fluocinolone patients ( = 0.30), with onset of 8-40 days (mean, 18 days) after surgery. IOP and number of glaucoma medications decreased at the 1-year postoperative visits in both the AGV group ( < 0.0001, < 0.0001) and the AGV + fluocinolone group ( = 0.001, < 0.0001). Compared to the AGV group, the AGV + fluocinolone group used fewer glaucoma medications (0.28 vs 1.30 [ = 0.01]) and had better inflammation control ( = 0.02). The surgical complication rates were similar between groups.

CONCLUSIONS

In uveitic glaucoma, AGV with fluocinolone achieves a similar, desired IOP control but with fewer glaucoma medications than AGV alone.

摘要

目的

比较葡萄膜炎性青光眼患者单纯行艾哈迈德青光眼引流阀（AGV）手术与AGV联合氟轻松植入术的眼压（IOP）结果。

方法

我们从马萨诸塞州眼耳医院眼部炎症数据库中确定了单纯行AGV手术以及AGV手术联合氟轻松植入术的葡萄膜炎性青光眼患者。在术前访视以及术后1、6和12个月记录人口统计学信息、视力和眼压。调查高血压期的发生率，高血压期定义为术后7天至6个月内任何时间眼压＞21 mmHg或使用额外治疗来降低眼压。采用多水平混合效应模型比较两组的结果。

结果

纳入了13例葡萄膜炎性青光眼患者的18只眼，这些患者有1年的随访数据。AGV组有9例患者的11只眼（平均年龄56.5岁；男性占63.6%），AGV联合氟轻松组有4例患者的7只眼（平均年龄61.3岁；男性占71.4%）。两组术后1年时视力变化无显著差异（P = 0.25），尽管AGV组视力改善显著（P = 0.01）。91%的AGV患者和43%的AGV联合氟轻松患者出现高血压期（P = 0.30），术后8 - 40天（平均18天）发病。AGV组（P < 0.0001，P < 0.0001）和AGV联合氟轻松组（P = 0.001，P < 0.0001）术后1年访视时眼压和青光眼药物使用数量均下降。与AGV组相比，AGV联合氟轻松组使用的青光眼药物更少（0.28比1.30 [P = 0.01]）且炎症控制更好（P = 0.02）。两组手术并发症发生率相似。