Elhusseiny Abdelrahman M, VanderVeen Deborah K
Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School , Boston, MA, USA.
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, MA, USA.
Semin Ophthalmol. 2020 Apr 2;35(3):194-204. doi: 10.1080/08820538.2020.1781906. Epub 2020 Jun 20.
Angle surgery is the gold standard for the management of many types of childhood glaucoma, yet glaucoma drainage devices (GDD) are effective tools for refractory advanced cases or secondary childhood glaucomas. The purpose of this article is to review recently published literature focused on the use of GDDs for pediatric glaucoma, including GDD general principles and surgical outcomes.
Literature review of various electronic databases was performed.
71 papers were reviewed for outcomes of GDD in childhood glaucomas. Success rates were usually defined by intraocular pressure (IOP) of 5-22 mmHg, with or without medications. Success rates were typically higher for non-valved GDDs but varied by length of follow-up. Non-valved GDDs afford lower and longer-lasting IOP control in pediatric eyes than valved GDD, however, no randomized controlled trials exist in childhood glaucoma.
Various designs of GDDs are available for management of childhood glaucoma with good short-term success rates; individual patient factors should be taken into consideration when selecting a specific device.
房角手术是多种儿童青光眼治疗的金标准,但青光眼引流装置(GDD)是难治性晚期病例或继发性儿童青光眼的有效治疗工具。本文旨在回顾近期发表的聚焦于GDD在儿童青光眼中应用的文献,包括GDD的一般原则和手术效果。
对各种电子数据库进行文献综述。
对71篇关于GDD在儿童青光眼中治疗效果的论文进行了综述。成功率通常以眼压(IOP)5 - 22 mmHg来定义,无论是否使用药物。无阀门GDD的成功率通常较高,但因随访时间长短而异。与有阀门GDD相比,无阀门GDD能在儿童眼中提供更低且更持久的眼压控制,然而,儿童青光眼尚无随机对照试验。
有多种设计的GDD可用于儿童青光眼的治疗,短期成功率良好;选择特定装置时应考虑个体患者因素。