Department of Ophthalmology, Northwestern University Feinberg School of Medicine.
Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
J Glaucoma. 2019 Oct;28(10):865-870. doi: 10.1097/IJG.0000000000001335.
In this retrospective case series, both Baerveldt and Ahmed glaucoma drainage devices resulted in good long-term outcomes in eyes with pediatric glaucoma following cataract surgery (GFCS).
The aim of this study was to describe the long-term safety and efficacy of primary glaucoma drainage device surgery in patients with pediatric GFCS.
We retrospectively identified 28 eyes of 28 patients with GFCS that underwent tube shunt surgery with the Ahmed Glaucoma Valve or Baerveldt Glaucoma Implant. The primary outcome measure was a surgical failure, defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on 2 consecutive follow-up visits after 3 months, IOP <5 mm Hg on 2 consecutive follow-up visits after 3 months, and reoperation for glaucoma.
The mean duration between cataract removal and the diagnosis of glaucoma was 3.6±1.5 years. Kaplan-Meier survival curves indicated a mean time to failure of 41.9±2.1 months after drainage device surgery. The cumulative probability of failure at 1, 2, 3, and 4 years was 3.6%, 19%, 28%, and 28%. IOP was significantly decreased from 29.3±4.1 mm Hg preoperatively to 17.6±1.6 mm Hg at the final follow-up visit (P<0.001). The number of glaucoma medications at baseline was 3.1±0.6, which decreased to 2.1±0.7 at the final visit (P=0.001).
Glaucoma drainage device surgery results in good long-term outcomes in patients with GFCS.
在这项回顾性病例系列研究中，Baerveldt 和 Ahmed 青光眼引流装置在小儿青光眼白内障手术后（GFCS）的眼睛中均取得了良好的长期结果。
本研究旨在描述原发性青光眼引流装置手术在小儿 GFCS 患者中的长期安全性和有效性。
我们回顾性地确定了 28 名 GFCS 患者的 28 只眼，这些患者接受了 Ahmed Glaucoma Valve 或 Baerveldt Glaucoma Implant 管分流手术。主要观察指标为手术失败，定义为术后 3 个月内连续 2 次随访时眼压（IOP）>21mmHg 或未降低 20%基线以下，术后 3 个月内连续 2 次随访时眼压<5mmHg，以及因青光眼再次手术。
白内障切除与青光眼诊断之间的平均时间间隔为 3.6±1.5 年。Kaplan-Meier 生存曲线表明，引流装置手术后平均失败时间为 41.9±2.1 个月。手术后 1、2、3 和 4 年的累积失败概率分别为 3.6%、19%、28%和 28%。眼压从术前的 29.3±4.1mmHg 显著降低至最后一次随访时的 17.6±1.6mmHg（P<0.001）。基线时的青光眼药物数量为 3.1±0.6，最后一次就诊时降至 2.1±0.7（P=0.001）。
青光眼引流装置手术在小儿 GFCS 患者中可获得良好的长期结果。
