摘要
目的探讨不同晶状体状态下Ahmed阀植入治疗硅油充填术后继发性青光眼的有效性及安全性。设计回顾性病例系列。研究对象2015年6月至2021年12月山东中医药大学附属眼科医院玻璃体切除联合硅油充填术后继发性青光眼Ahmed阀植入患者62例(62眼)。方法回顾患者术前及术后3个月的病历资料。分为有晶状体眼组26例(26眼)、人工晶状体(introcular lens,IOL)眼组16例(16眼)、无晶状体眼组20例(20眼)。手术成功定义为术后使用或不使用抗青光眼药物情况下眼压6~21 mmHg、无严重并发症、不需实施其他抗青光眼手术。主要指标手术成功率、眼压、降眼压药物的数量、硅油是否进入引流管、并发症发生率。结果术后3个月时手术成功率为85.5%,有晶状体眼组、IOL眼组、无晶状体眼组手术成功率分别为96.2%、87.5%、70.0%(P=0.041)。有晶状体眼手术成功率高于无晶状体眼(P=0.033),其他组间两两比较差异无统计学意义。术后3个月眼压有晶状体眼组(16.93±1.75)mmHg、IOL眼组(18.45±2.78)mmHg均低于无晶状体眼组(22.56±3.10)mmHg(P均<0.01)。术前使用降眼压药物数量为4(4,5)种,术后为0(0,1.25)种(Z=6.96,P=0.000)。三组间术前及术后降眼压药物数量均无统计学差异。术后三组硅油进入引流管的比例分别为1/26、2/16、6/20(P=0.041)。术后三组浅前房发生率分别为2/26、2/16、0/20(P=0.282)。前房出血发生率分别为2/26、2/16、2/20(P=0.871)。无其他严重并发症发生。结论有晶状体眼和IOL眼Ahmed阀植入治疗硅油充填术后继发性青光眼的手术成功率高于无晶状体眼。无晶状体眼硅油进入引流管的风险较高。(眼科,2022,31:340-345)
Objective To evaluate the safety and efficacy of Ahmed glaucoma valve in the treatment of refractory glaucoma in eyes with silicone oil tamponade under different lens statuses.Design Retrospective case series.Participants 62 patients(62 eyes)with refractory glaucoma after vitrectomy with silicone oil tamponade who were admitted to the glaucoma department of the Eye Hospital affiliated to Shandong University of Traditional Chinese Medicine from June 2015 to December 2021.Methods The medical records of the patients before and after operation 3 months later were reviewed.Included patients(eyes)were divided into three groups:phakic group(26 patients 26 eyes),IOL group(16 patients,16 eyes)and aphakic group(20 patients,20 eyes).The successful operation is defined as the introcular pressure(IOP)being 6~21 mmHg with or without the anti-glaucoma drugs after the operation,without serious complications and other anti-glaucoma operations.Main Outcome Measures The success rate,IOP,the number of anti-glaucoma drugs and the incidence of silicone oil entering drainage tube,the incidence of other complications.Results The total post-operative success rate was 85.5%for all patients 3 months later.The success rate of phakic eyes,IOL eyes and aphakic eyes was 96.2%,87.5%,70.0%respectively,with significant difference among the three groups(P=0.041).The success rate of phakic eyes was higher than aphakic eyes(P=0.033),with no significant difference among the other groups.The IOP of phakic eyes(16.93±1.75)mmHg and pseudophakic eyes(18.45±2.78)mmHg were lower than aphakic eyes(22.56±3.10)mmHg after 3-month follow-up,with statistically significant difference among the three groups(all P<0.01).The number of anti-glaucoma drugs used before the operation was 4(4,5)and was 0(0,1.25)after operation for all patients,the difference was statistically significant(Z=6.96,P=0.000).There was no significant difference in the number of anti-glaucoma drugs used before and after operation among the three groups.The proportion of silicone oil entering
作者
杜秀娟
王艺蓉
沙芳
孙璇
毕宏生
Du Xiujuan;Wang Yirong;Sha Fang;Sun Xuan;Bi Hongsheng(Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine,Shandong Academy of Eye Disease Prevention and Therapy,Jinan 250002,China)
出处
《眼科》
CAS
2022年第5期340-345,共6页
Ophthalmology in China
基金
山东省医药卫生科技发展计划项目(2019WS566)
山东省中医药科技发展计划项目(2019-0251)。
