Namdev Vaibhav, Panigrahi Arnav, Arora Monika, Gupta Viney, Gupta Shikha
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2022 May;70(5):1812-1814. doi: 10.4103/ijo.IJO_2677_21.
The presence of emulsified silicone oil in the eye can lead to many complications, glaucoma being one of the most common. Adequate IOP control is difficult to achieve with medical management alone; surgical intervention is often required. Glaucoma drainage device implantation is often the preferred line of surgical intervention in such cases due to trabeculectomy failure from emulsified silicone oil droplets and associated conjunctival scarring. However, the silicone tube of Ahmed glaucoma valve (AGV) may attract the silicone oil droplets, causing blockade of the tube with persistent raised IOP postoperatively. We report one such case where post-AGV silicone oil tube occlusion was treated with semi-conservative surgical management instead of revising the entire surgery or implantation of another drainage device. Our surgical technique of intracameral "vent and flush" offers rapid and effective IOP control in such cases. Postoperatively, normal IOP was achieved. Patency of tube continued to be maintained along with normalization of IOP on subsequent follow-ups.
眼内乳化硅油的存在可导致许多并发症，青光眼是最常见的并发症之一。仅通过药物治疗很难实现充分的眼压控制；通常需要手术干预。由于乳化硅油滴导致小梁切除术失败及相关结膜瘢痕形成，青光眼引流装置植入术在这类病例中往往是首选的手术干预方式。然而，艾哈迈德青光眼阀（AGV）的硅胶管可能会吸引硅油滴，导致术后硅胶管堵塞，眼压持续升高。我们报告了这样一例病例，AGV术后硅胶油管阻塞采用半保守手术治疗，而非重新进行整个手术或植入另一个引流装置。我们的前房内“排气和冲洗”手术技术在此类病例中能快速有效地控制眼压。术后眼压恢复正常。在随后的随访中，眼压持续正常，硅胶管通畅得以维持。
