Nguyen Q H, Budenz D L, Parrish R K
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Fla 33101, USA.
Arch Ophthalmol. 1998 May;116(5):571-5. doi: 10.1001/archopht.116.5.571.
To report the incidence and identify risk factors of postoperative complications after Baerveldt glaucoma drainage implantation.
A retrospective review of the medical records of all patients at the Bascom Palmer Eye Institute, Miami, Fla, who underwent placement of a Baerveldt glaucoma drainage implant from October 1, 1992, through October 31, 1996, to determine demographic characteristics, preoperative and postoperative intraocular pressures, and complications. Variables were analyzed using the Student t test and Fisher exact test to determine the association between delayed postoperative suprachoroidal hemorrhage and various potential risk factors.
A total of 107 eyes of 103 patients were identified. Suprachoroidal hemorrhage occurred in 4 eyes (4%), with onset ranging from 3 to 33 days after implantation. Two eyes (2%) had choroidal effusions requiring surgical drainage, and 20 eyes (19%) had low choroidal effusions requiring only close observation. Tube blockage was observed in 5 eyes (5%). Four eyes (4%) had aqueous misdirection, 2 eyes (2%) had corneal decompensation, and 1 eye (1%) each had endophthalmitis, tube migration, corneal ulcer, hyphema, and implant migration. Patients who were older (P=.04) or had postoperative choroidal effusions (P=.03), low intraocular pressure immediately after the tube opened (P=.03), hypertension (P= .08), or atherosclerosis (P=.09) were more likely to develop suprachoroidal hemorrhage.
A lower incidence of serious postoperative complications was observed in Baerveldt implantations in this study when compared with a recent report. Risk factors for serious complications were similar to trabeculectomy.
报告贝尔维尔德青光眼引流植入术后并发症的发生率并确定其危险因素。
回顾性分析1992年10月1日至1996年10月31日在佛罗里达州迈阿密巴斯科姆帕尔默眼科研究所接受贝尔维尔德青光眼引流植入术的所有患者的病历，以确定人口统计学特征、术前和术后眼压以及并发症。使用学生t检验和费舍尔精确检验分析变量，以确定术后迟发性脉络膜上腔出血与各种潜在危险因素之间的关联。
共确定了103例患者的107只眼。4只眼（4%）发生脉络膜上腔出血，发病时间为植入后3至33天。2只眼（2%）有脉络膜渗漏需要手术引流，20只眼（19%）有低度脉络膜渗漏仅需密切观察。5只眼（5%）观察到引流管堵塞。4只眼（4%）发生房水错流，2只眼（2%）发生角膜失代偿，1只眼（1%）分别发生眼内炎、引流管移位、角膜溃疡、前房积血和植入物移位。年龄较大（P = 0.04）或术后有脉络膜渗漏（P = 0.03）、引流管打开后立即眼压低（P = 0.03）、高血压（P = 0.08）或动脉粥样硬化（P = 0.09）的患者更易发生脉络膜上腔出血。
与最近的一份报告相比，本研究中贝尔维尔德植入术的严重术后并发症发生率较低。严重并发症的危险因素与小梁切除术相似。
