Bao Ning, Jiang Zheng-Xuan, Coh Paul, Tao Li-Ming
Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
Department of Ophthalmology, University of California, San Francisco 94143-0730, California, USA.
Int J Ophthalmol. 2018 Apr 18;11(4):629-634. doi: 10.18240/ijo.2018.04.15. eCollection 2018.
To report long-term outcomes of secondary glaucoma due to uveitis treated with Ahmed glaucoma valve (AGV) implantation in a series of Chinese patients.
The retrospective study included 67 eyes from 56 patients with uveitic glaucoma who underwent AGV implantation. Success of the treatment was defined as patients achieving intraocular pressure (IOP) levels between 6 and 21 mm Hg with or without additional anti-glaucoma medications and/or a minimum of 20% reduction from baseline IOP. The main outcome measurements included IOP, the number of glaucoma medications at 1, 3, 6, 12, 24, 36, 48 and 60mo after surgery, surgical complications, final best-corrected vision acuity (BCVA), visual field (VF) and retinal nerve fiber layer (RNFL).
The mean follow-up was 53.3±8.5 (range 48 to 60)mo. The cumulative probability of success rate was 98.5%, 95.5%, 89.6%, 83.6%, 76.1%, 70.1%, 65.7% and 61.2% at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively. IOP was reduced from a baseline of 30.8±6.8 to 9.9±4.1, 10.1±4.2, 10.9±3.7, 12.9±4.6, 13.8±3.9, 13.2±4.6, 12.3±3.5 and 13.1±3.7 mm Hg at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively (<0.01). The number of postoperative glaucoma medications was significantly decreased compared with baseline at all time points during the study period (<0.05). There was no significant difference between preoperative and postoperative BCVA. Remarkable surgical complications were not found after surgery. The VF and RNFL of the patients were stable after the surgery.
AGV implantation is safe and effect in terms of reducing IOP, decreasing the number of glaucoma medications, and preserving vision for patients with uveitic glaucoma.
报告一系列中国患者中，采用艾哈迈德青光眼引流阀（AGV）植入术治疗葡萄膜炎继发青光眼的长期疗效。
这项回顾性研究纳入了56例葡萄膜炎性青光眼患者的67只眼睛，这些患者均接受了AGV植入术。治疗成功的定义为患者眼压（IOP）达到6至21毫米汞柱，无论是否使用额外的抗青光眼药物，和/或眼压较基线至少降低20%。主要观察指标包括眼压、术后1、3、6、12、24、36、48和60个月时的青光眼药物使用数量、手术并发症、最终最佳矫正视力（BCVA）、视野（VF）和视网膜神经纤维层（RNFL）。
平均随访时间为53.3±8.5（范围48至60）个月。在术后1、3、6、12、24、36、48和60个月时，成功率的累积概率分别为98.5%、95.5%、89.6%、83.6%、76.1%、70.1%、65.7%和61.2%。眼压从基线的30.8±6.8毫米汞柱分别降至术后1、3、6、12、24、36、48和60个月时的9.9±4.1、10.1±4.2、10.9±3.7、12.9±4.6、13.8±3.9、13.2±4.6、12.3±3.5和13.1±3.7毫米汞柱（<0.01）。在研究期间的所有时间点，术后青光眼药物使用数量与基线相比均显著减少（<0.05）。术前和术后BCVA无显著差异。术后未发现明显的手术并发症。患者术后的视野和视网膜神经纤维层保持稳定。
对于葡萄膜炎性青光眼患者，AGV植入术在降低眼压、减少青光眼药物使用数量和保护视力方面是安全有效的。
