The Sam Rothberg Glaucoma Center, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University.
Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Glaucoma. 2021 Jun 1;30(6):502-507. doi: 10.1097/IJG.0000000000001813.
Ahmed glaucoma valve (AGV) implantation without plate fixation resulted in high rates of complications related to plate or tube movement.
Scleral suturing of the plate of AGV is associated with technical difficulty and potential complications. This study summarizes the surgical outcomes of 10 years of experience with AGV implantation without suture plate fixation.
The medical records of all glaucoma patients who underwent AGV implantation surgery without plate fixation between 2009 and 2019 at the Sheba Medical Center (Tel Hashomer, Israel) were retrospectively reviewed. Clinical data on intraoperative and postoperative complications, best-corrected visual acuity, intraocular pressure, and number of intraocular pressure-lowering medications were retrieved.
Included were 95 eyes of 95 patients (53 men, 42 women; mean age, 54.9±17.5 y). The mean follow-up was 687±673 days. In total, 37 patients (37/95, 38.%) had AGV-related complications, of whom 28 (29.5%) required additional intervention. Women had a significantly higher rate of complications than men (21/42, 50% vs. 16/53, 30.2%, respectively, P=0.049). The 2 most common complications were AGV migration in 13 eyes (13.7%) and tube exposure/AGV extrusion in 9 eyes (9.5%). AGV was removed in 10 cases.
In this cohort, omitting suture AGV plate fixation resulted in high rates of complications related to plate or tube movement, the need for further intervention, and AGV removal. Therefore, we cannot recommend this surgical technique.
Ahmed 青光眼引流阀（AGV）植入时不固定引流阀盘，导致与盘或管移动相关的并发症发生率较高。
AGV 盘的巩膜缝线固定与技术难度和潜在并发症有关。本研究总结了 10 年来不固定引流阀盘行 AGV 植入术的手术结果。
回顾性分析了 2009 年至 2019 年在以色列谢巴医疗中心（Tel Hashomer）行无盘固定的 AGV 植入术的所有青光眼患者的病历。检索术中及术后并发症、最佳矫正视力、眼内压和降眼压药物数量等临床资料。
共纳入 95 例患者（53 例男性，42 例女性；平均年龄 54.9±17.5 岁）的 95 只眼。平均随访 687±673 天。共有 37 只眼（37/95，38.9%）发生了与 AGV 相关的并发症，其中 28 只眼（29.5%）需要进一步干预。女性的并发症发生率明显高于男性（21/42，50% vs. 16/53，30.2%，P=0.049）。最常见的两种并发症是 13 只眼（13.7%）的 AGV 移位和 9 只眼（9.5%）的引流管外露/AGV 脱出。10 只眼（10.5%）的 AGV 被取出。
在本队列中，省略 AGV 盘缝线固定导致了与盘或管移动相关的高并发症发生率、需要进一步干预和 AGV 取出。因此，我们不能推荐这种手术技术。
