摘要
目的:评估平坦部青光眼阀植入联合玻璃体切除全视网膜光凝术治疗继发性闭角型新生血管性青光眼(neovascular glaucoma,NVG)的临床效果。方法:对2007-05/2008-08在我科治疗的连续伴玻璃体积血的继发性闭角型NVG患者14例16眼行玻璃体切除视网膜光凝联合平坦部青光眼阀植入术并随访观察。结果:术后追踪随访3～13(平均7.3)mo。16只术眼中,除3眼外视力均不同程度提高。经秩和检验术前和术后两组相差显著。眼压由术前用降压药后的38～67(平均48.5±9.3)mmHg降至15.6～25.3(平均16.5±6.9)mmHg,两组相差有统计学意义。4眼出现术后并发症。其中2眼角膜水肿、前房炎症。1眼脉络膜脱离。经药物对症治疗后缓解。1眼出现医源性白内障。结论:玻璃体切除全视网膜光凝联合平坦部青光眼阀植入术是有效和安全的。特别是对于伴浅前房的NVG患者是一种新的治疗选择。
AIM： To observe the efficacy and safety of the pars plana Ahmed glaucoma valve implant combined with vitrectomy and panretinal photocoagulation for the management of neovascular glaucoma （NVG） in patients with vitreous hemorrhage and shallow anterior chamber. METHODS： The records of 16 eyes of 14 consecutive patients with NVG who had undergone vitrectomy and pars plana Ahmed valve implant were evaluated. The patients were observed for a mean time of 7.3 months. RESULTS： Mean preoperative intraocular pressure （IOP） with oral and topical anti-glaucoma medications was 48.5 ± 9.3mmHg, and mean postoperative lOP without anti-glaucoma medications was 16.5± 6.9mmHg （ P 〈 0.05） at the final visit. Visual acuity in all patients was improved in varying degree except for 3 eyes. There were four eyes of each of the following adverse events： choroidal effusion, corneal edema, inflammatory reaction of anterior chamber and latrogenic cataract. CONCLUSION： Pars plana and Ahmed valve implantation seems to be a viable and safe surgical option in the management of NVG with shallow anterior chamber and vitreous hemorrhage with a relatively low rate of serious postoperative complications.
出处
《国际眼科杂志》
CAS
2009年第10期1890-1891,共2页
International Eye Science
