Rapuano C J, Schmidt C M, Cohen E J, Rajpal R K, Raber I M, Katz L J, Wilson R P, Laibson P R, Kremer I
Cornea Service, Wills Eye Hospital, Philadelphia, PA 19107.
Cornea. 1995 Jan;14(1):26-32.
The association of glaucoma and penetrating keratoplasty presents a difficult management problem, particularly when medical therapy and conventional glaucoma surgery have failed. We have found alloplastic tube shunt surgery to be an effective method for intraocular pressure control in glaucomatous eyes subjected to penetrating keratoplasty. We report 46 patients who underwent alloplastic tube shunt implantation before (13 patients, group A), in combination with (17 patients, group B), or after (16 patients, group C) penetrating keratoplasty. All groups had significantly lowered intraocular pressure postoperatively. The most common complication was graft failure, in 31% of patients in group A, 29% in group B, and 44% in group C. Other postoperative complications and results including visual outcome are reviewed. Because the management of advanced glaucoma in patients undergoing keratoplasty is difficult, alloplastic tube shunt implantation should be considered.
青光眼与穿透性角膜移植的关联带来了棘手的治疗难题，尤其是在药物治疗和传统青光眼手术均告失败之时。我们发现，对于接受穿透性角膜移植的青光眼患者，异体材料管分流手术是控制眼压的有效方法。我们报告了46例患者，他们在穿透性角膜移植术前（13例，A组）、术中（17例，B组）或术后（16例，C组）接受了异体材料管分流植入术。所有组术后眼压均显著降低。最常见的并发症是植片失败，A组31%的患者、B组29%的患者以及C组44%的患者出现了该并发症。还对包括视力转归在内的其他术后并发症及结果进行了回顾。由于角膜移植患者晚期青光眼的治疗难度较大，应考虑行异体材料管分流植入术。
