Coleman A L, Hill R, Wilson M R, Choplin N, Kotas-Neumann R, Tam M, Bacharach J, Panek W C
Jules Stein Eye Institute, UCLA School of Medicine 90024-7004, USA.
Am J Ophthalmol. 1995 Jul;120(1):23-31. doi: 10.1016/s0002-9394(14)73755-9.
We studied the Ahmed Glaucoma Valve implant, an aqueous shunting device that has a unidirectional valve mechanism designed to prevent postoperative hypotony in eyes with intractable glaucoma.
In this multicenter, prospective clinical trial, we studied 60 eyes (60 patients) with increased intraocular pressure or glaucoma that had not responded to medical treatment, laser photocoagulation, or previous glaucoma surgery, in which the Ahmed Glaucoma Valve implant was placed to decrease intraocular pressure.
Success was defined as intraocular pressure less than 22 mm Hg and greater than 4 mm Hg for two months or longer, intraocular pressure that was lowered by at least 20% from preoperative values (in eyes with preoperative intraocular pressures less than 22 mm Hg), and no additional glaucoma surgery or visually devastating complications. Cumulative probability of success at 12 months was 78%. Eight (13%) of 60 eyes had intraocular pressure less than 5 mm Hg the first postoperative day. Two other eyes had shallow anterior chambers, which required anterior chamber reformation. The major complications associated with the use of the valve were serous choroidal detachments in 13 eyes (22%), blockage of the tube in six eyes (10%), malposition of the tube in four eyes (7%), a suprachoroidal hemorrhage in one eye (2%), and corneal graft rejections in three (19%) of 16 eyes with corneal grafts.
Although the 12-month success with the Ahmed Glaucoma Valve implant is similar to that reported for other drainage devices, the complications associated with overfiltration in the immediate postoperative period appear to be less frequent than with other valved drainage devices. Randomized, prospective studies to compare the Ahmed Glaucoma Valve implant with other drainage devices are needed to make clinical comparisons of the different devices.
我们研究了艾哈迈德青光眼引流阀植入物，这是一种房水引流装置，具有单向瓣膜机制，旨在防止难治性青光眼患者术后出现低眼压。
在这项多中心前瞻性临床试验中，我们研究了60只眼（60例患者），这些患者眼压升高或患有青光眼，对药物治疗、激光光凝或先前的青光眼手术均无反应，通过植入艾哈迈德青光眼引流阀来降低眼压。
成功的定义为眼压低于22mmHg且高于4mmHg持续两个月或更长时间，眼压较术前值降低至少20%（术前眼压低于22mmHg的眼），且无需额外的青光眼手术或导致视力严重受损的并发症。12个月时的累积成功概率为78%。60只眼中有8只（13%）在术后第一天眼压低于5mmHg。另外两只眼出现浅前房，需要进行前房重建。与使用该瓣膜相关的主要并发症包括13只眼（22%）发生浆液性脉络膜脱离，6只眼（10%）引流管堵塞，4只眼（7%）引流管位置不当，1只眼（2%）发生脉络膜上腔出血，以及16只接受角膜移植的眼中有3只（19%）发生角膜移植排斥反应。
尽管艾哈迈德青光眼引流阀植入物12个月时的成功率与其他引流装置报道的相似，但术后早期与过度引流相关的并发症似乎比其他带瓣膜引流装置更少。需要进行随机前瞻性研究，将艾哈迈德青光眼引流阀植入物与其他引流装置进行比较，以便对不同装置进行临床比较。
