前房型Ahmed房水引流物植入治疗难治性青光眼的并发症的预防及处理  

Preventive control in the complications of Ahmed valve implantation via anterior chamber for refractory glaucoma

作　　者：王海瑛[1] 盛晓捷 孙艳[1] 朱洪丽[1] 

机构地区：[1]中国辽宁省沈阳市第四人民医院眼科,110031

出　　处：《国际眼科杂志》2006年第4期890-892,共3页International Eye Science

摘　　要：目的:探讨前房型Ahmed房水引流物植入术治疗难治性青光眼术中术后并发症的预防及处理,提高手术的成功率。方法:对2003/2005之间于我院行前房型Ahmed房水引流物植入后的20例难治性青光眼患者的术中术后并发症进行回顾性分析。结果:随访时间4～23mo。平均眼压水平由35.3±5.2mmHg(1mmHg=0.133kPa)降低至18.6±4.4mmHg,成功率为90%。13例完全成功(65%),包括早期低眼压4例、浅前房6例、前房积血4例、引流管口阻塞3例、脉络膜脱离1例;5例条件成功者(25%)包括引流盘周纤维化4例、暴发性脉络膜出血1例,仍需辅以降眼压药物控制眼压;2例因持续性高眼压导致失败。结论:通过前房植入Ahmed房水引流物术中术后并发症复杂多发,但经过及时妥善的处理仍可达到理想的疗效。AIM： To investigate the cause of the complications and suitable control measures of Ahmed valve implantation via anterior chamber for refractory glaucoma and to improve success ratio. METHODS： In the period from 2003 to 2005, retrospective study of operative and postoperative application was based on 20 eyes which underwent Ahmed valve implantation via anterior chamber for refractory glaucoma. RESULTS： Follow-up was 4 to 23 months. Mean intraocular pressure （IOP） was lower from 35.3± 5.2mmHg to 18.6± 4.4mmHg. The outcomes of the study showed that the success rate was 90%. Thirteen cases （65%） had completely success, including 4 cases had early hypotony, 6 cases had shallow anterior chamber, 4 cases had anterior chamber hemorrhage, 3 cases had obstruction of the drainage entrance, 1 cases had choroidal detachment. 5 cases had incompletely success, including 3 cases had fibrosis around Ahmed valve, 1 case had superchoroidal hemorrhage, IOP lowering medications were still necessary. Two cases were failure for persistent high intraocular pressure. CONCLUSION： Despite complications are complex and happened frequently, we can also believe that refractory glaucoma Ahmed valve implantation via anterior chamber is a satisfactory and safe procedure underwent timely and appropriate control measures.

关 键 词：并发症 难治性青光眼 Ahmed减压阀 前房 

分 类 号：R779.6[医药卫生—眼科]