Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Oporto, Portugal.
ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Oporto, Portugal.
Eur J Ophthalmol. 2024 Jul;34(4):NP25-NP28. doi: 10.1177/11206721241247584. Epub 2024 Apr 13.
Glaucoma is a progressive optic neuropathy and it is the main cause of irreversible blindness worldwide. Intraocular pressure (IOP) is the only modifiable one and trabeculectomy is commonly considered the surgical "gold standard" to decrease IOP. In particular cases, other kind of surgeries, as the Ahmed Glaucoma Valve (AGV) implant, are a reliable alternative. Usually, the silicone tube of AGV surgery is inserted into the anterior chamber. Sometimes it is necessary to place the AGV silicone tube in the ciliary sulcus, especially in cases of endothelial decompensation. This surgical procedure is not always easy to perform.
This article describes and presents a technique for inserting the AGV tube into the posterior chamber using a guide-wire, in a total of 12 cases are reported. This procedure has been mostly applied in a group of pseudophakic patients who need AGV placement to control elevated IOP. In exceptional situations, this procedure was applied in pseudophakic patients previously with AGV tube implanted in the anterior chamber and with loss of endothelial cells or in phakic patients with previously implanted AGV anterior chamber tube, simultaneously to cataract surgery.
The purpose of these cases presentations attended at our service is to demonstrate the passage of the AGV silicone tube was performed with the aid of a guide wire.
青光眼是一种进行性视神经病变,是全球范围内导致不可逆性失明的主要原因。眼压(IOP)是唯一可调节的因素,小梁切除术通常被认为是降低 IOP 的手术“金标准”。在特殊情况下,其他类型的手术,如 Ahmed 青光眼引流阀(AGV)植入术,是一种可靠的替代方法。通常,AGV 手术的硅胶管被插入前房。在某些情况下,需要将 AGV 硅胶管放置在睫状体沟内,尤其是在内皮细胞失代偿的情况下。这种手术操作并不总是容易进行。
本文描述并介绍了一种使用导丝将 AGV 管插入后房的技术,共报告了 12 例病例。该方法主要应用于一组需要 AGV 植入以控制眼压升高的无晶状体患者。在特殊情况下,该方法应用于先前在前房植入 AGV 管且内皮细胞丧失的无晶状体患者,或同时进行白内障手术的先前在前房植入 AGV 管的有晶状体患者。
我们科室报告这些病例的目的是展示在导丝的辅助下,AGV 硅胶管的通过情况。