Stringa Francesco, Chen Ruth, Agrawal Pavi
Department of Ophthalmology, University Hospital Southampton, NHS Foundation Trust, United Kingdom.
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
J Curr Glaucoma Pract. 2022 Jan-Apr;16(1):20-23. doi: 10.5005/jp-journals-10078-1351.
Long-term data of the postoperative management following Baerveldt tube surgery (BVT) is currently limited. This study aims to evaluate the outcome and the safety profile of internal ligation suture removal after BVT surgery for refractory glaucoma.
A prospective, consecutive, non-comparative case series of patients previously undergoing BVT 350 mm surgery with 0.4 mg/mL mitomycin C (MMC), 3/0 intraluminal suture (Supramid) insertion, and 10/0 nylon external ligation suture(s). For each patient, data was collected over 12 months after internal ligation suture removal. Follow-up assessments looked at intraocular pressure (IOP), complication rate, and postoperative number of glaucoma medications. Definition of success was adopted as per the World Glaucoma Association recommendations.
Twenty-four patients were included. On average, Supramid was removed at 22 ± 18.2 weeks following BVT surgery. Preoperatively, the mean IOP was 30.9 ± 12.6 mm Hg and the average antiglaucoma medications were 1.95 ± 1.13. At 12 months, the mean IOP was 15.2 ± 5.3 mm Hg and the mean number of glaucoma medications was 1.3 ± 0.2. Qualified success with IOP ≤ 21 mm Hg and IOP ≤ 15 mm Hg was achieved in 62.5% and 33.3%, respectively. Only two patients developed hypotony following Supramid removal; both resolved spontaneously within 1 month.
Our results show a good IOP reduction and safety profile at 1 year from internal ligation suture removal following BVT. A drop in IOP of approximately 50% from the preoperative IOP can be expected.
Stringa F, Chen R, Agrawal P. One-year Outcomes Following Internal Ligation Suture Removal in 350 mm Baerveldt Tube Implant Surgery. J Curr Glaucoma Pract 2022;16(1):20-23.
目前，关于贝尔韦尔德特管手术（BVT）术后长期管理的数据有限。本研究旨在评估难治性青光眼患者接受BVT手术后内结扎缝线拆除的效果和安全性。
这是一项前瞻性、连续性、非对照病例系列研究，研究对象为之前接受过350mm BVT手术、术中使用0.4mg/mL丝裂霉素C（MMC）、插入3/0腔内缝线（Supramid）以及10/0尼龙外结扎缝线的患者。对每位患者，在拆除内结扎缝线后的12个月内收集数据。随访评估包括眼压（IOP）、并发症发生率以及术后青光眼药物使用数量。成功的定义采用世界青光眼协会的建议。
纳入24例患者。平均而言，BVT手术后22±18.2周拆除Supramid缝线。术前，平均眼压为30.9±12.6mmHg，平均抗青光眼药物使用数量为1.95±1.13。在12个月时，平均眼压为15.2±5.3mmHg，平均青光眼药物使用数量为1.3±0.2。眼压≤21mmHg和眼压≤15mmHg的合格成功率分别为62.5%和33.3%。拆除Supramid缝线后仅有2例患者发生低眼压；均在1个月内自行缓解。
我们的结果显示，BVT术后拆除内结扎缝线1年后眼压降低效果良好且安全性良好。预计眼压较术前可降低约50%。
Stringa F, Chen R, Agrawal P. 350mm贝尔韦尔德特管植入手术拆除内结扎缝线后的1年结果。《当代青光眼实践杂志》2022；16(1):20 - 23。
