Department of Ophthalmology, Dokuz Eylul University School of Medicine, 35340, Izmir, Turkey.
Int Ophthalmol. 2022 Mar;42(3):969-980. doi: 10.1007/s10792-021-02080-w. Epub 2021 Oct 10.
To evaluate the clinical outcomes of pseudophakic/aphakic eyes with uncontrolled glaucoma that underwent Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus.
Medical records of the patients who underwent Ahmed glaucoma valve implantation through the ciliary sulcus, between December 2017 and June 2019, were reviewed retrospectively. Patients' age, gender, glaucoma diagnosis, visual acuity, intraocular pressure levels, and complications were recorded.
Forty-seven eyes of 43 patients with glaucoma were enrolled. The mean age was 54.5 ± 19.9 years (range, 7-88 years) at the time of surgery, and the mean postoperative follow-up period was 7.9 ± 3.4 months (range, 3-16 months). The mean preoperative intraocular pressure level was 35.2 ± 6.8 mmHg (range, 25-55 mmHg), and it was found as 15.6 ± 5.4 mmHg (range, 9-33 mmHg) at the last follow-up visit. Decrease in intraocular pressure level was statistically significant (P < 0.001). At the last follow-up visit, success (postoperative IOP ≥ 6 mmHg and ≤ 21 mmHg with or without antiglaucomatous medications, without further surgery for IOP control, without loss of light perception and without removal of the implant) was achieved in 41 eyes (87.2%). Hyphema was the most common postoperative complication and developed in 11 eyes (23.4%) and resolved spontaneously in all of them within one month.
In pseudophakic or aphakic eyes with uncontrolled glaucoma, placement of Ahmed glaucoma valve tube in the ciliary sulcus is a safe and effective procedure. Ciliary sulcus can be considered as a potential space during tube shunt surgery in eyes with high risk of tube-corneal touch or corneal decompensation.
评估睫状沟内植入 Ahmed 青光眼引流阀(引流管置于睫状沟)治疗未控制的青光眼伴白内障/无晶状体眼的临床效果。
回顾性分析 2017 年 12 月至 2019 年 6 月期间行睫状沟内 Ahmed 青光眼引流阀植入术的患者的病历资料。记录患者的年龄、性别、青光眼诊断、视力、眼压水平及并发症等。
共纳入 43 例(47 只眼)青光眼患者。手术时的平均年龄为 54.5±19.9 岁(范围 7-88 岁),平均术后随访时间为 7.9±3.4 个月(范围 3-16 个月)。术前平均眼压为 35.2±6.8mmHg(范围 25-55mmHg),末次随访时为 15.6±5.4mmHg(范围 9-33mmHg),眼压水平降低有统计学意义(P<0.001)。末次随访时,41 只眼(87.2%)达到手术成功标准,即术后眼压≥6mmHg 且≤21mmHg,无需进一步手术控制眼压,无光感丧失,未取出植入物。术后最常见的并发症是前房积血,11 只眼(23.4%)发生该并发症,所有患者均在 1 个月内自发吸收。
对于未控制的青光眼伴白内障/无晶状体眼,睫状沟内植入 Ahmed 青光眼引流阀是一种安全有效的治疗方法。在高危发生引流管与角膜接触或角膜失代偿的情况下,睫状沟可作为引流管手术的潜在空间。