Zhu Yingting, Lin Shufen, Fang Lei, Chen Liming, Liu Pingping, Zhong Yimin, Liu Xing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, 510060, China.
BMC Ophthalmol. 2025 Mar 28;25(1):157. doi: 10.1186/s12886-025-03980-6.
Congenital fibrovascular pupillary membranes in secondary glaucoma (CFPMSG) is kind of refractory childhood glaucoma. The aim of the study is to evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implants in CFPMSG.
Twelve patients with CFPMSG who underwent anterior chamber reconstruction (ASR) with a stable anterior chamber but uncontrolled intraocular pressure (IOP) underwent AGV implantation. Patients with a follow-up period of > 12 months were enrolled. Demographic data were collected. All patients underwent comprehensive ophthalmic examinations before and after surgeries, including IOP measurement, A- and B-scan ultrasonography, and ultrasound biomicroscopy (UBM), etc. Success was defined as postoperative intraocular pressure (IOP) ≤ 21 mmHg with (qualified success) or without (complete success) the use of glaucoma drugs.
The median age of enrolled patients was 15.1 ± 12.5 months old (range 4.5-46) and 58.3% of them were female. At last follow-up (32.0 ± 16.0 months), the average IOP was declined (postoperative: 18.7 ± 4.5 mmHg vs. preoperative: 29.0 ± 4.0 mmHg, p < 0.001). The number of glaucoma drugs decreased from 3 (range 2-3) to 1.5 (range 0-3) (P < 0.001), while the anterior chamber depth (ACD) remained stable (3.21 ± 0.70 mm and 3.40 ± 0.82 mm, respectively) (p = 0.57) after AGV implantation. The complete success rate was 25% (3/12) and the qualified success rate was 58.3% (7/12). The total success rate was 83.8%. No severe complications were noted.
This study demonstrated that AGV implants could be safe and effective for CFPMSG with uncontrolled IOP. AGV implantation is a feasible option for the treatment of CFPMSG.
继发性青光眼合并先天性纤维血管性瞳孔膜（CFPMSG）是一种难治性儿童青光眼。本研究的目的是评估Ahmed青光眼引流阀（AGV）植入术治疗CFPMSG的有效性和安全性。
12例CFPMSG患者接受了前房重建（ASR），前房稳定但眼压（IOP）控制不佳，随后接受了AGV植入术。纳入随访时间>12个月的患者。收集人口统计学数据。所有患者在手术前后均接受了全面的眼科检查，包括眼压测量、A超和B超超声检查以及超声生物显微镜检查（UBM）等。成功定义为术后眼压（IOP）≤21 mmHg，使用（合格成功）或不使用（完全成功）青光眼药物。
纳入患者的中位年龄为15.1±12.5个月（范围4.5-46岁），其中58.3%为女性。在最后一次随访时（32.0±16.0个月），平均眼压下降（术后：18.7±4.5 mmHg vs.术前：29.0±4.0 mmHg，p<0.001）。青光眼药物的使用数量从3种（范围2-3种）减少到1.5种（范围0-3种）（P<0.001），而AGV植入术后前房深度（ACD）保持稳定（分别为3.21±0.70 mm和3.40±0.82 mm）（p=0.57）。完全成功率为25%（3/12），合格成功率为58.3%（7/12）。总成功率为83.8%。未观察到严重并发症。
本研究表明，AGV植入术治疗IOP控制不佳的CFPMSG可能是安全有效的。AGV植入术是治疗CFPMSG的一种可行选择。
