Ahmed青光眼引流阀植入治疗先天性青光眼术后眼压失控疗效分析

Clinical evaluation of Ahmed glaucoma valve implantation for uncontrolled primary congenital glaucoma

摘要:

目的：探讨Ahmed青光眼引流阀植入治疗先天性青光眼术后眼压失控的疗效与安全性。

方法：回顾分析了2011-01/2014-12因先天性青光眼术后眼压失控患者22例22眼，行青光眼引流阀植入术。主要检查指标包括手术前后眼压、角膜直径以及并发症。

结果：术前平均年龄3.74±2.24岁，距上次手术平均2.59±1.78a，术前平均眼压35.22±6.36mmHg，平均水平角膜直径12.79±0.75mm。所有眼术中使用丝裂霉素C 0.3～0.5mg/mL 3～5min，青光眼引流阀植入颞上或鼻上方巩膜赤道部。术后1wk眼压11.4±4.45mmHg，术后12mo随访眼压16.73±7.23mmHg。以眼压<21mmHg为成功标准，术后12mo 16眼(73%)眼压控制。术后6例发生浅前房，均自行恢复。所有患者未发生引流阀排斥及眼内炎、角膜失代偿等严重并发症。

结论：Ahmed青光眼引流阀植入治疗先天性青光眼术后眼压失控，是一种安全、有效的方法。

Abstract:

AIM: To investigate the outcome and safety of Ahmed glaucoma valve implantation treatment in uncontrolled primary congenital glaucoma(PCG).

METHODS:Twenty-two eyes in 22 children with uncontrolled PCG were reviewed retrospectively and underwent Ahmed glaucoma valve implantation treatment from January 2011 to December 2014. Main checking index included intraocular pressure(IOP)before and after operation, corneal diameter and complications.

RESULTS: Preoperative mean age was 3.74±2.24y, and 2.59±1.78y apart from the last operation. Postoperative average IOP was 35.22±6.36mmHg. Average corneal diameter was 12.79±0.75mm. Mitomycin C(0.3-0.5mg/mL)was used in all operations for 3-5min. Glaucoma valves were implanted in the temporal or nose above the equator sclera. Postoperative IOP was 11.4±4.45mmHg at 1wk, and 16.73±7.23mmHg after 12mo. As IOP<21mmHg for success criteria, IOP of 16 eyes(73%)were controlled after 12mo. Preoperative 6 cases had shallow anterior chamber, recovered spontaneously. No serious complication was recorded, such as rejection of glaucoma valve, endoophthalmitis and corneal decompensation.

CONCLUSION: Ahmed glaucoma valve implantation in uncontrolled PCG is a safe and viable treatment.