Lin Zhong-Jing, Chen Zheng-Hua, Huang Shou-Yue, Sun Jun, Shen Xi, Zhong Yi-Sheng
Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao Tong University, Shanghai 200025, China.
Department of Ophthalmology, Suzhou Eye and ENT Hospital, Suzhou 215006, Jiangsu Province, China.
Int J Ophthalmol. 2020 May 18;13(5):832-836. doi: 10.18240/ijo.2020.05.20. eCollection 2020.
To describe the clinical results of combined Ahmed valve implantation and 23-gauge vitrectomy for medically uncontrolled neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR).
The medical records of medically uncontrolled NVG patients with PDR who underwent Ahmed valve implantation and 23-gauge vitrectomy between March 2016 and December 2018 were reviewed. Enrolled patients had at least 6-month follow-up. Panretinal photocoagulation (PRP), anti-vascular endothelial growth factor, surgery and medication history were documented.
Eleven eyes of 11 patients were included in our study. The visual acuity improved in 8 eyes and remained unchanged in 3 eyes. The preoperative intraocular pressure (IOP) was significantly decreased at the last follow-up (48.8±4.3 to 17.0±1.5 mm Hg, <0.001). All eyes needed three topical anti-glaucomatous medications before surgery, but the number was significantly reduced to 0.72±0.19 at the last visit (<0.001). Four eyes had choroidal detachment and 3 eyes had minor hyphemia, all of which gradually resolved without treatments in one week.
Ahmed glaucoma valve implantation combined with 23-gauge vitrectomy might be a safe and alternative treatment for NVG with PDR.
描述 Ahmed 瓣膜植入联合 23G 玻璃体切除术治疗因增殖性糖尿病视网膜病变（PDR）导致的药物控制不佳的新生血管性青光眼（NVG）的临床效果。
回顾性分析 2016 年 3 月至 2018 年 12 月期间接受 Ahmed 瓣膜植入联合 23G 玻璃体切除术治疗的药物控制不佳的 PDR 合并 NVG 患者的病历。纳入患者均进行了至少 6 个月的随访。记录全视网膜光凝（PRP）、抗血管内皮生长因子治疗、手术及用药史。
本研究共纳入 11 例患者的 11 只眼。8 只眼视力提高，3 只眼视力无变化。末次随访时，术前眼压显著降低（48.8±4.3 至 17.0±1.5 mmHg，<0.001）。术前所有患眼均需三种局部抗青光眼药物治疗，但末次随访时用药数量显著减少至 0.72±0.19（<0.001）。4 只眼发生脉络膜脱离，3 只眼有少量前房积血，所有这些情况在一周内未经治疗均逐渐消退。
Ahmed 青光眼瓣膜植入联合 23G 玻璃体切除术可能是治疗 PDR 合并 NVG 的一种安全有效的替代治疗方法。
