青少年特发性关节炎相关葡萄膜炎患者的手术性青光眼治疗：小梁切除术或 Ahmed 青光眼引流阀植入术后的结果。
Surgical Glaucoma Treatment in Patients with Juvenile Idiopathic Arthritis-Associated Uveitis: Results after Trabeculectomy or Ahmed Glaucoma Valve Implantation.
机构信息
Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany.
Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany.
出版信息
Ocul Immunol Inflamm. 2024 Jul;32(5):636-641. doi: 10.1080/09273948.2023.2185263. Epub 2023 Mar 10.
PURPOSE
Patients with juvenile idiopathic arthritis (JIA) associated uveitis (JIAU) are at risk for secondary glaucoma, frequently requiring surgical management. We compared the success rates for trabeculectomy (TE) and Ahmed glaucoma valve (AGV) implantation.
METHODS
We conducted a retrospective analysis of TE (45 eyes), primary AGV (pAGV) (7 eyes), or secondary AGV (sAGV) implantation after TE (11 eyes) in JIAU at the 2-year follow-up.
RESULTS
All groups achieved significant pressure reduction. After 1 year, the overall success rate was higher in the Ahmed groups ( = 0.03). After adjusting the -value according to Benjamin Hochberg, there is no significant difference between the groups in the Kaplan-Meier, despite a significant logrank test between all groups ( = 0.0194) and a better performance in the Ahmed groups.
CONCLUSION
Slightly better success rates were achieved with pAGV in managing JIAU patients with glaucoma refractory to medical treatment.
目的
患有幼年特发性关节炎（JIA）相关葡萄膜炎（JIAU）的患者有发生继发性青光眼的风险，通常需要手术治疗。我们比较了小梁切除术（TE）和 Ahmed 青光眼引流阀（AGV）植入的成功率。
方法
我们对 JIAU 患者在 2 年随访时进行了小梁切除术（45 只眼）、原发性 Ahmed 青光眼引流阀（pAGV）（7 只眼）或小梁切除术后继发性 Ahmed 青光眼引流阀（sAGV）植入（11 只眼）的回顾性分析。
结果
所有组均实现了显著的降压效果。在第 1 年，Ahmed 组的总体成功率更高（ = 0.03）。根据 Benjamin Hochberg 调整 值后，尽管各组之间的 Kaplan-Meier 存在显著差异（ = 0.0194），且 Ahmed 组的表现更好，但各组之间没有统计学差异。
结论
对于药物治疗无效的青光眼 JIAU 患者，使用原发性 Ahmed 青光眼引流阀治疗可获得略高的成功率。
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