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Ahmed青光眼引流阀植入术在玻璃体切除术后眼中的应用

Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes.

作者信息

Erçalık Nimet Yeşim, İmamoğlu Serhat

机构信息

Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey.

出版信息

J Ophthalmol. 2018 May 10;2018:9572805. doi: 10.1155/2018/9572805. eCollection 2018.

Abstract

PURPOSE

To evaluate the outcomes of Ahmed glaucoma valve (AGV) implantation in vitrectomized eyes.

MATERIALS AND METHODS

The medical records of 13 eyes that developed glaucoma due to emulsified silicon oil or neovascularization following pars plana vitrectomy and underwent AGV implantation were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of antiglaucoma medications, and postoperative complications. Surgical success was defined as last IOP ≤21 mmHg or ≥6 mmHg and without loss of light perception.

RESULTS

The mean follow-up duration was 11.7 ± 5.5 (range, 6-23) months. The mean IOP before the AGV implantation was 37.9 ± 6.7 mmHg with an average of 3.5 ± 1.2 drugs. At the final visit, the mean IOP was 15.9 ± 4.6 mmHg (=0.001) and the mean number of glaucoma medications decreased to 2.3 ± 1.3 (=0.021). At the last visit, 11 eyes (84.4%) had stable or improved VA and one eye (7.7%) had a final VA of no light perception. Surgical success was achieved in 11 of the 13 eyes (84.4%). Postoperative complications were bleb encapsulation (69.2%), early hypotony (38.5%), hyphema (23.1%), decompression retinopathy (23.1%), choroidal detachment (15.4%), intraocular hemorrhage (7.7%), and late endophthalmitis (7.7%). One eye (7.7%) was enucleated because of late endophthalmitis.

CONCLUSIONS

Despite complications necessitating medical and surgical interventions, vitrectomized eyes were effectively managed with AGV implantation.

摘要

目的

评估在接受玻璃体切割术的眼中植入艾哈迈德青光眼引流阀(AGV)的效果。

材料与方法

回顾性分析13例因扁平部玻璃体切割术后硅油乳化或新生血管形成而发生青光眼并接受AGV植入术的患者的病历。主要观察指标为眼压(IOP)、最佳矫正视力(BCVA)、抗青光眼药物数量及术后并发症。手术成功定义为末次眼压≤21 mmHg或较术前降低≥6 mmHg且无光感丧失。

结果

平均随访时间为11.7±5.5(范围6 - 23)个月。AGV植入术前平均眼压为37.9±6.7 mmHg,平均使用3.5±1.2种药物。末次随访时,平均眼压为15.9±4.6 mmHg(P = 0.001),平均抗青光眼药物数量降至2.3±1.3种(P = 0.021)。末次随访时,11只眼(84.4%)视力稳定或提高,1只眼(7.7%)最终无光感。13只眼中11只(84.4%)手术成功。术后并发症包括滤过泡包裹(69.2%)、早期低眼压(38.5%)、前房积血(23.1%)、减压性视网膜病变(23.1%)、脉络膜脱离(15.4%)、眼内出血(7.7%)和晚期眼内炎(7.7%)。1只眼(7.7%)因晚期眼内炎而眼球摘除。

结论

尽管存在需要药物和手术干预的并发症,但AGV植入术能有效治疗接受玻璃体切割术的眼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0239/5971286/0b2712964b4d/JOPH2018-9572805.001.jpg

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