Pakravan Mohammad, Hekmat Vahid Reza, Pakravan Parto, Hassanpour Kiana, Esfandiari Hamed
1 Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur J Ophthalmol. 2019 Jan;29(1):57-60. doi: 10.1177/1120672118761458. Epub 2018 Mar 27.
: To introduce a new technique of short tunnel small flap graft-free glaucoma drainage device implantation and report our early experience.
: In a retrospective study, patients with uncontrolled primary open-angle glaucoma underwent short tunnel small flap graft-free Ahmed glaucoma valve implantation. In this technique, plate is sutured 8-10 mm posterior to the limbus and a partial thickness flap is made at 1 or 11 o'clock position, 1 mm posterior the limbus. Tube was passed through a tunnel immediately anterior to the plate into the proximal edge of the flap and then inserted into the anterior chamber via a route underneath the flap. Flap then covered the distal end of the tube and conjunctiva was sutured. Patients were followed for a minimum of 12 months for any sign of tube exposure and rise of intraocular pressure.
: A total of 16 consecutive patients with refractory primary open-angle glaucoma and uncontrolled intraocular pressure were included in this study. Mean age of participants was 59 ± 8.3 years and nine (56%) were male. Mean intraocular pressure at the time of presentation was 26 ± 6.2 mm Hg, which dropped to 16 ± 4.5 at 12 months postoperative follow-up. The number of medications at baseline was 3 ± 1 eye drops, which was decreased to 1 ± 1.2 at 12 months. There were no conjunctival and flap-related complications or any sign of tube exposure during 1-year postoperative period.
: Short tunnel small flap graft-free glaucoma drainage device implantation technique combines advantages of both tunneling and flap techniques. Also, it may result in better tube positioning and more favorable cosmetic outcomes.
介绍一种新型的短隧道小瓣无移植青光眼引流装置植入技术，并报告我们的早期经验。
在一项回顾性研究中，对原发性开角型青光眼控制不佳的患者进行短隧道小瓣无移植艾哈迈德青光眼阀植入术。在该技术中，将引流盘缝合于角膜缘后8 - 10毫米处，并在角膜缘后1毫米的1点或11点位置制作一个部分厚度的瓣。将引流管通过引流盘前方紧邻的隧道穿入瓣的近端边缘，然后经瓣下方的路径插入前房。瓣随后覆盖引流管的远端，缝合结膜。对患者进行至少12个月的随访，观察有无引流管暴露和眼压升高的迹象。
本研究共纳入16例连续的原发性开角型青光眼难治性患者，眼压控制不佳。参与者的平均年龄为59±8.3岁，9例（56%）为男性。就诊时的平均眼压为26±6.2毫米汞柱，术后12个月随访时降至16±4.5毫米汞柱。基线时使用的药物数量为3±1种眼药水，12个月时降至1±1.2种。术后1年内无结膜和瓣相关并发症，也无引流管暴露的迹象。
短隧道小瓣无移植青光眼引流装置植入技术结合了隧道技术和瓣技术的优点。此外，它可能导致更好的引流管定位和更理想的美容效果。
