Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
J Glaucoma. 2021 Apr 1;30(4):362-367. doi: 10.1097/IJG.0000000000001749.
Ahmed glaucoma valve (AGV) implantation led to a significant reduction in intraocular pressure (IOP) and in antiglaucoma medications in vitrectomized eyes in previously nonglaucomatous eyes. The most common indication for vitrectomy was ocular trauma-related complications.
The purpose of this study was to report the long-term outcomes of AGV implantation in patients of uncontrolled IOP after pars plana vitrectomy (PPV).
Medical records of patients (age 18 y and above) who underwent AGV implantation between January 2006 and December 2017 for uncontrolled IOP following PPV with ≥2 years follow-up were reviewed. The underlying etiology for PPV, IOP, best-corrected visual acuity, and number of antiglaucoma medications (AGMs) were recorded at baseline. The main outcomes measures were IOP, number of AGM, best-corrected visual acuity, and postoperative complications. Postoperative complications were classified as early (≤3 mo)/intermediate (>3 mo to ≤1 y), or late (>1 y).
In all, 78 eyes of 78 patients with a mean age of 38.06±17.83 years were included. The mean follow-up was 70.46±36.96 (range: 24 to 180) months. The main underlying etiology for PPV was trauma (38.4%) followed by rhegmatogenous retinal detachment (28.2%). The mean preoperative IOP was 29.33±9.84 mm Hg with an average of 4.07±1.2 AGM. The mean IOP and number of AGM was significantly reduced in all follow-up visits (P<0.0001) following AGV implantation. The cumulative probability of success was 92.3%, 80.7%, and 74% at 2, 5, and 10 years, respectively. Thirty-one complications were observed in 25 (32%) eyes and reoperation (23 procedures) was performed in 22 (28.2%) eyes.
AGV implantation had good outcome in patients with intractably elevated IOP following PPV. Trauma-related pathologies were a major contributor to the indications for PPV and had more chances of failure following AGV implantation.
本研究旨在报告 Ahmed 青光眼阀（AGV）植入治疗接受过玻璃体切除术（PPV）后眼压（IOP）控制不佳的患者的长期结果。
回顾了 2006 年 1 月至 2017 年 12 月期间因 PPV 后 IOP 控制不佳且有≥2 年随访而接受 AGV 植入术的患者的病历。记录了基线时的潜在病因、IOP、最佳矫正视力和抗青光眼药物（AGM）数量。主要观察指标为 IOP、AGM 数量、最佳矫正视力和术后并发症。术后并发症分为早期（≤3 个月）/中期（>3 个月至≤1 年）和晚期（>1 年）。
共纳入 78 例 78 只眼患者，平均年龄为 38.06±17.83 岁。平均随访时间为 70.46±36.96（范围：24 至 180）个月。PPV 的主要潜在病因是创伤（38.4%），其次是孔源性视网膜脱离（28.2%）。术前平均 IOP 为 29.33±9.84mmHg，平均使用 4.07±1.2 种 AGM。AGV 植入后所有随访时的平均 IOP 和 AGM 数量均显著降低（P<0.0001）。AGV 植入后 2、5 和 10 年的累积成功率分别为 92.3%、80.7%和 74%。25 只（32%）眼观察到 31 种并发症，22 只（28.2%）眼进行了 23 次再手术。
AGV 植入术对接受过 PPV 治疗后眼压持续升高的患者有良好的疗效。与创伤相关的病变是导致行 PPV 的主要原因，并且在接受 AGV 植入后更有可能失败。
