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在葡萄膜炎性青光眼的引流管手术后,引流管类型对管-角膜接触和角膜失代偿的发生率的影响。

Effect of shunt type on rates of tube-cornea touch and corneal decompensation after tube shunt surgery in uveitic glaucoma.

机构信息

Wills Eye Hospital, Glaucoma Research Center, 840 Walnut Street, Suite 1140, Philadelphia, PA, 19107, USA.

Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Jun;259(6):1587-1595. doi: 10.1007/s00417-021-05095-2. Epub 2021 Jan 30.

Abstract

PURPOSE

To evaluate the effect of tube shunt type [Ahmed (AGV) versus Baerveldt (BGI)] on the frequency of tube-cornea touch and corneal decompensation after tube shunt surgery.

METHODS

This retrospective comparative study included 145 eyes of 130 patients with uveitic glaucoma who underwent AGV (75 eyes) or BGI (70 eyes) implantations. Electronic medical records were reviewed to document demographic factors, intraocular pressure (IOP) reduction, frequency of tube-cornea touch, corneal decompensation, and need for subsequent corneal transplantation.

RESULTS

The mean follow-up was 27.7±3.3 months for AGV and 32.8±3.8 months for BGI (p=0.30). Tube-cornea touch was observed in 5 eyes after BGI and 1 eye in the AGV group (p=0.08). The BGI group reported a significantly higher rate of corneal decompensation (9 versus 0; p=0.001) and transplantation (6 versus 0; p=0.01) compared to the AGV group. Previous trabeculectomy was a significant risk factor for corneal complications in eyes undergoing BGI implantation (odds ratio [OR]= 8.17, 95% confidence interval [CI]=1.78-37.45, p=0.007).

CONCLUSION

Similar rates of tube-cornea touch were observed in both shunt types; BGI shunts were associated with a greater incidence of corneal complications and transplantation as compared to AGV in this retrospective series of uveitic glaucoma cases.

摘要

目的

评估引流管类型[Ahmed (AGV) 与 Baerveldt (BGI)]对引流管手术后管角膜接触和角膜失代偿的频率的影响。

方法

本回顾性对照研究纳入了 130 例患有葡萄膜炎性青光眼的患者的 145 只眼,这些患者分别接受了 AGV(75 只眼)或 BGI(70 只眼)植入术。回顾电子病历以记录人口统计学因素、眼内压(IOP)降低、管角膜接触频率、角膜失代偿以及后续角膜移植的需要。

结果

AGV 的平均随访时间为 27.7±3.3 个月,BGI 的平均随访时间为 32.8±3.8 个月(p=0.30)。BGI 组有 5 只眼发生管角膜接触,AGV 组有 1 只眼发生管角膜接触(p=0.08)。BGI 组的角膜失代偿(9 只眼对比 0 只眼;p=0.001)和移植(6 只眼对比 0 只眼;p=0.01)的发生率明显高于 AGV 组。BGI 植入前的小梁切除术是导致角膜并发症的显著危险因素(比值比[OR]=8.17,95%置信区间[CI]=1.78-37.45,p=0.007)。

结论

在这一系列回顾性葡萄膜炎性青光眼病例中,两种类型的引流管都有相似的管角膜接触率;与 AGV 相比,BGI 引流管与更高的角膜并发症和移植发生率相关。

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