摘要
目的观察改良Ahmed青光眼引流阀植入术治疗难治性青光眼的临床疗效。方法回顾性系列病例研究。收集2011年1月至2013年12月采用改良Ahmed青光眼引流阀植入术治疗难治性青光眼患者46例（47眼）的临床资料，术中将引流盘置入筋膜下间隙，无需缝线固定，距离角膜缘约5mm处以及角膜缘处各做一放射状浅层巩膜隧道（长约6mm），将引流管穿入浅层巩膜隧道并遮盖。患者随访时间为术后l周、1个月、6个月以及以后每6个月复查一次，直至末次复查，随访内容主要包括患者术后眼压、最佳矫正视力（BCVA）、并发症、应用抗青光眼药物种类等。手术后不同时间点的眼压比较采用重复测量资料的方差分析，手术前后应用抗青光眼药物种类比较采用秩和检验，术前与末次随访视力比较采用等级资料秩和检验。结果术前与末次复查视力比较，差异无统计学意义。术前眼压为（43．3±8．1）mmHg，术后末次随访眼压为（15．3±5．9）mmHg，差异有统计学意义（F=12．16，P〈0．05）。术前、术后末次随访抗青光眼药物使用种类分别为4、1种，比较差异有统计学意义（Z=7．32，P〈0．05）。Ahmed青光眼引流阀植入术完全成功率为72％．条件成功率为87％。术后并发症主要包括前房出血、引流管口堵塞、浅前房、引流盘周围包裹性囊状泡，对症处理后眼压均可控制。结论改良Ahmed青光眼引流阀植入术治疗难治性青光眼，操作简便。手术时间短，术后并发症少，是治疗难治性青光眼的有效方法。
Objective To explore the efficacy of a modified technique with Ahmed glaucoma valve （AGV） implantation in the treatment of refractory glaucoma. Methods This retrospective study included a total of 47 eyes of 46 refractory glaucoma patients who underwent a modified Ahmed glaucoma valve implantation in Wuhan Aier Hospital from January 2011 to December 2013. The sutureless AGV implantation technique was as follows： The drainage plate was secured between the episclera and Tenon＇s capsule with no suture placement. An approximate 6 mm radical scleral tunnel was made from 5 mm to the limbus and near the limbus respectively, and the drainage tube was inserted through the tunnel, followed by a selerotomy at the limbus through which the tube was introduced into the anterior chamber. The extraoeular portion of the tube was covered. Best corrected visual acuity （BCVA）, intraocular pressure （IOP） and the number of anti-glaucoma medications before and after the surgery and postoperative complications were evaluated. Patients were followed up and postoperative data was obtained at 1 week, 1 month, 6 months, and then at 6-month intervals after surgery. Comparsions of lOP at different time points after surgery were performed by using repeat mesured ANOVA; while a paired nonparametric rank sum test was used to compare the number of glaucoma medications, and visual acuity preoperatively and postoperatively or at the last follow-up. Results Visual acuity was not significantly different between pre-operation and the final follow-up （Z=1.826, P〉0.05）. Preoperative IOP varied from 15 to 69 mmHg, and IOP was between 9 and 23 mmHg at the final follow-up. The mean IOP was significantly reduced from a preoperative 43.26＋8.14 mmHg to a postoperative 15.3~5.9 mmHg （F=12.16, P〈0.05）. The number of anti-glaucoma medications was significantly reduced from 4 at preoperation to 1 postoperatively （Z=7.32, P〈0.05）. At the last visit, the complete success rate of the AVG implantation reached 72.3%, and the conditi
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2015年第8期502-505,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science
