Un Yasemin, Imamoglu Serhat
Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, 34668, Uskudar, Istanbul, Turkey.
Int Ophthalmol. 2024 Feb 7;44(1):25. doi: 10.1007/s10792-024-02918-z.
To investigate the clinical outcomes of Ahmed glaucoma valve (AGV) implantation in primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG).
The patients who underwent AGV implantation for POAG and PEXG between January 2015 and December 2021 in a single tertiary center eye clinic were reviewed retrospectively. Thirty-one eyes with the diagnosis of POAG constituted Group 1 and 40 eyes with the diagnosis of PEXG constituted Group 2. The primary outcome measures were intraocular pressure (IOP) changes after AGV implantation and surgical success at the last visit. We evaluated complete and qualified surgical success using the following three criteria: (1) IOP ≤ 21mmH g, (2) IOP ≤ 18 mmHg, and (3) IOP ≤ 15 mmHg, as well as the absence of any serious complications, such as light perception loss and phthisis bulbi, and additional de novo glaucoma surgery.
The mean follow-up times were 25.2 (± 21.4) months and 27.6 (± 19.8) months for Groups 1 and 2, respectively (p > 0.05). In Groups 1 and 2, the mean preoperative IOPs were 31.9 ± 9.4 mmHg and 32.3 ± 8.4 mmHg, respectively, which significantly reduced to 14.5 ± 0.7 mmHg and 11.6 ± 0.6 mmHg, respectively at the last postoperative visit (p < 0.001 for both). The mean IOP value at the last visit was statistically significantly lower in Group 2 (p = 0.006). At the last visit, the number of eyes with qualified success according to criteria 1, 2, and 3 was 26 (83.9%), 25 (80.6%), and 18 (58.1%), respectively, in Group 1 and 39 (97.5%), 39 (97.5%), and 32 (80%), respectively, in Group 2. The comparison of the qualified success rates showed statistically significantly higher rates in Group 2 for criterion 2 (p = 0.038).
AGV implantation had high success rates in both POAG and PEXG, but at the final visit, lower IOP levels were reached in the latter.
探讨艾哈迈德青光眼引流阀（AGV）植入术治疗原发性开角型青光眼（POAG）和剥脱性青光眼（PEXG）的临床效果。
回顾性分析2015年1月至2021年12月在某单一三级中心眼科诊所接受AGV植入术治疗POAG和PEXG的患者。诊断为POAG的31只眼构成第1组，诊断为PEXG的40只眼构成第2组。主要观察指标为AGV植入术后眼压（IOP）变化及末次随访时的手术成功率。我们采用以下三项标准评估完全成功和合格的手术成功率：（1）眼压≤21mmHg，（2）眼压≤18mmHg，（3）眼压≤15mmHg，以及无任何严重并发症，如光感丧失和眼球痨，且无需额外的新生青光眼手术。
第1组和第2组的平均随访时间分别为25.2（±21.4）个月和27.6（±19.8）个月（p>0.05）。在第1组和第2组中，术前平均眼压分别为31.9±9.4mmHg和32.3±8.4mmHg，术后末次随访时分别显著降至14.5±0.7mmHg和11.6±0.6mmHg（两者p<0.001）。第2组末次随访时的平均眼压值在统计学上显著更低（p=0.006）。末次随访时，根据标准1、2和3，第1组合格成功的眼数分别为26只（83.9%）、25只（80.6%）和18只（58.1%），第2组分别为39只（97.5%）、39只（97.5%）和32只（80%）。合格成功率的比较显示，第2组在标准2方面的成功率在统计学上显著更高（p=0.038）。
AGV植入术在POAG和PEXG中均有较高的成功率，但在末次随访时，PEXG达到的眼压水平更低。
