Mercieca Karl
Klinik für Augenheilkunde, Universität Bonn, Ernst-Abbe-Str. 2, 53117, Bonn, Deutschland.
Ophthalmologie. 2023 Apr;120(4):372-377. doi: 10.1007/s00347-023-01846-0. Epub 2023 Apr 25.
Glaucoma drainage devices (tubes, GDI or GDD) are nowadays an important surgical option in the treatment of refractory glaucoma. They are frequently used in cases where previous glaucoma surgery has failed or in patients with a history of conjunctival scarring where other procedures are contraindicated or simply not possible. This article looks at the evolution of glaucoma drainage implants from the very beginning to the multiple designs, experiences and research studies that have made tubes an essential part of the armamentarium of modern glaucoma surgeons. The article describes the first concepts and then proceeds to the first commercialized devices which led to the widespread use of tubes such as Molteno®, Baerveldt® and Ahmed®. Finally, it looks at the innovations that have been carried out, particularly over the last decade with the advent of new tubes, such as Paul®, eyeWatch® and Ahmed ClearPath®. The factors associated with the success and failure of GDD surgery, including the indications, are different from those for trabeculectomy and increasing experience and larger amounts of data have helped glaucoma surgeons to become more comfortable with selecting the most appropriate procedure for the individual patients.
青光眼引流装置（引流管、青光眼引流植入物或青光眼引流装置）如今是治疗难治性青光眼的一种重要手术选择。它们常用于既往青光眼手术失败的病例，或有结膜瘢痕病史且其他手术禁忌或根本无法进行的患者。本文探讨了青光眼引流植入物从最初到多种设计、经验及研究的演变过程，正是这些使得引流管成为现代青光眼外科医生手术器械库的重要组成部分。文章先介绍了最初的概念，接着讲述了首批商业化装置，这些装置促使引流管如莫尔顿（Molteno）®、贝尔维德（Baerveldt）®和艾哈迈德（Ahmed）®得以广泛应用。最后，文章着眼于所取得的创新成果，尤其是过去十年随着新型引流管如保罗（Paul）®、眼监护（eyeWatch）®和艾哈迈德ClearPath®的出现所带来的创新。青光眼引流装置手术成败相关的因素，包括适应证，与小梁切除术不同，并且经验的增加和更多的数据已帮助青光眼外科医生在为个体患者选择最合适的手术时更加得心应手。
