Dept of Ophthalmology, Zhejiang Yiwu Aier Eye Hospital, Jinhua, 322000, China.
Dept of Ophthalmology, Zhejiang Ningbo Aier Eye Hospital, Ningbo, 315100, China.
BMC Ophthalmol. 2024 Oct 4;24(1):435. doi: 10.1186/s12886-024-03694-1.
To evaluate the effectiveness and safety of a method for repairing an eroded Ahmed glaucoma valve (AGV) tube using two short scleral tunnels made in tandem with a 22G needle instead of covering the eroded tube with another scleral graft.
From May 12, 2015, to July 27, 2019, we retrospectively reviewed eight patients at Ningbo Aier Eye Hospital who developed AGV tube erosion secondary to necrosis of their overlying conjunctiva and scleral grafts. This defect was repaired in all the patients using the double short tandem scleral tunnel technique, which involved the creation of double short tandem scleral tunnels made by a 22G needle. Two parallel-to-limbus scleral incisions were made 3 mm and 6 mm from the limbus first, then a curved 22G needle was inserted between the two scleral cuts to make one scleral tunnel, the other scleral tunnel was completed during the first surgery, inserted the tube into the two tunnels. The mean length of time between the AGV placement and the first erosion was 12.25 ± 6.36 months (3-24 months). The mean age of the patients was 65.50 ± 11.70 years (49-78 years).
The surgical outcome was assessed in terms of the tectonic integrity of the conjunctiva over the follow-up period (12 months). There was no AGV tube erosion, scleral thinning, or ocular infection after a mean of 41.25 ± 26.54 months of follow-up in all eight patients.
AGV tube erosion following shunt surgery can be successfully managed using the improved double short tandem scleral tunnel technique.
评估使用两根 22G 针串联制作的两个短巩膜隧道修复侵蚀性 Ahmed 青光眼阀（AGV）管的有效性和安全性，而不是用另一片巩膜移植物覆盖侵蚀的管。
2015 年 5 月 12 日至 2019 年 7 月 27 日，我们回顾性分析了在宁波艾儿眼科医院因覆盖其上的结膜和巩膜移植物坏死而继发 AGV 管侵蚀的 8 例患者。所有患者均采用双短串联巩膜隧道技术修复该缺陷，该技术涉及使用 22G 针制作双短串联巩膜隧道。首先在距角膜缘 3mm 和 6mm 处做两个平行于角膜缘的巩膜切口，然后将弯曲的 22G 针插入两个巩膜切口之间，制作一个巩膜隧道，在第一次手术中完成另一个巩膜隧道，将管插入两个隧道中。AGV 放置与第一次侵蚀之间的平均时间为 12.25±6.36 个月（3-24 个月）。患者的平均年龄为 65.50±11.70 岁（49-78 岁）。
在随访期（12 个月），根据结膜在随访期间的结构完整性评估手术结果。所有 8 例患者在平均随访 41.25±26.54 个月后，均未出现 AGV 管侵蚀、巩膜变薄或眼感染。
使用改良的双短串联巩膜隧道技术可成功治疗分流术后的 AGV 管侵蚀。
