目的：探究Ahmed青光眼引流阀植入术对外伤性房角后退性青光眼患者视力、眼压及角膜内皮细胞密度的影响。

方法：本组探究对象选择2014-06/2016-06于我院治疗的33例35眼外伤性房角后退性青光眼患者，所有患者均运用Ahmed青光眼引流阀植入术治疗。现回顾性分析所有患者的病历资料，评价手术成功率； 通过非接触式眼压计测量治疗前、治疗1wk，1、3、6mo，1a后的眼压； 采用角膜内皮镜检测并计算治疗前、治疗1wk，1、3、6mo，1a后的角膜内皮细胞密度； 并比较术前、术后1a所有患眼的视力情况，随访、复诊，记录所有患者的并发症情况。

结果：患者35眼中手术绝对成功率为54%，相对成功率为40%，总成功率94%，失败率为6%； 手术前后无光感、光感、≤0.01、>0.01～0.10、>0.10～0.20眼数比较差异无统计学意义(Z=-0.132，P=0.362)； 治疗前眼压43.43±3.65mmHg，术后1wk 13.50±2.54mmHg，术后1mo 15.93±2.61，术后6mo 16.00±2.18mmHg，术后1a 16.45±2.21mmHg，各时间点眼压比较差异具有统计学意义(F=887.82，P<0.05)； 治疗后1wk，1、3、6mo，1a眼压较治疗前降低，差异有统计学意义(P<0.05)，而治疗后各时间点两两比较差异均无统计学意义(P>0.05)。治疗前、术后1wk，1、3、6mo，1a角膜内皮细胞密度分别为2443.35±343.12、2231.67±334.45、2065.47±336.45、2031.47±345.76、2001.72±337.18、1979.65±301.32个/mm²，各时间点角膜内皮细胞密度差异具有统计学意义(F=13.49，P<0.05)，治疗后1wk，1、3、6mo，1a角膜内皮细胞密度较治疗前降低，差异有统计学意义(P<0.05)，而治疗后各时间点两两比较差异均无统计学意义(P>0.05)。术后出现低眼压4例4眼，前房出血3例3眼，引流管口堵塞2例2眼，高眼压2例2眼，经简单干预治疗后迅速缓解。

结论：外伤性房角后退性青光眼采用Ahmed青光眼引流阀植入术能显著改善高眼压状态，能够保护残存视力，部分患者视力改善，并发症轻微且简单干预后缓解，但存在一定的术后角膜内皮细胞丢失现象。

METHODS: Totally 33 cases(35 eyes)of patients with traumatic angle recession glaucoma admitted to our hospital since June 2014 to June 2016 were selected and treated with Ahmed glaucoma valve implantation. The clinical data of all patients were retrospectively analyzed, so as to evaluated to success rate of surgery. Non-contact tonometer was applied to surveying intraocular pressure before treatment and at 1wk, 1,3,6mo and 1a post treatment. Specular microscope was adopted to examine and calculate the corneal endothelial cell density before treatment and at 1wk, 1,3,6mo and 1a post treatment. All affected eyes were compared for visual acuity before surgery and in 1a after surgery, moreover, patients were followed-up, received the further consultations and the complications were recorded.

RESULTS: As for 35 affected eyes, the absolute success rate of surgery was 54%, while the relative success rate was 40%, and the total successful rate and failure rate were 94% and 6% respectively. In terms of the number of people who had no light sensation before surgery, or who had light sensation, ≤0.01, 0.01-0.10 or >0.10-0.20, there was no significant difference(Z=-0.132, P=0.362). The intraocular pressure before treatment was 43.43±3.65mmHg, at 1wk after surgery was 13.50±2.54mmHg, at 1mo was 15.93±2.61mmHg,at 6mo was 16.00±2.18mmHg and at 1a was 16.45±2.21mmHg, and the difference among different time points had statistical significance(F=887.82, P<0.01). After treatment the intraocular press decreased compared to before treatment(P<0.05); those after treatment had no difference with each other(P>0.05). Before treatment, the corneal endothelial cell density was 2443.35±343.12 pieces/mm², in 1wk after the surgery was 2231.67±334.45 pieces /mm², in 1mo after the surgery was 2065.47±336.45 pieces /mm², in 3mo after surgery was 2031.47±345.76 pieces/mm², in 6mo was 2001.72±337.18 pieces /mm² and in 1a after the surgery was 1979.65±301.32 pieces /mm², and the difference among different time points had statistical significance(F=13.49, P<0.01). After treatment the corneal endothelial cell density decreased compared to before treatment(P<0.05); those after treatment had no difference with each other(P>0.05). After surgery, there were 4 cases(4 eyes)of ocular hypotension, 3 cases(3 eyes)of hyphema, 2 cases(2 eyes)of drainage tube plugging and 2 cases(2 eyes)of intraocular hypertension, which were all quickly relieved after basic intervention treatment.

CONCLUSION: Treating traumatic angle recession glaucoma with Ahmed glaucoma valve implantation can dramatically optimize the state of intraocular hypertension and protect the retaining visual acuity, and visual acuity can be optimized in some cases. It causes little complication that can be relieved with basic prognosis, but postoperative corneal endothelial cell loss exists in some cases.