Ahmed青光眼阀植入术治疗硅油填充术后继发性青光眼的远期疗效  

Long-term clinical results of Ahmed glaucoma valve implantation on glaucoma eyes containing silicone oil

作　　者：叶长华[1] 厉君[1] 周丹[1] 林丁[1] 

机构地区：[1]长沙爱尔眼科医院,湖南省长沙市410015

出　　处：《眼科新进展》2012年第11期1074-1076,共3页Recent Advances in Ophthalmology

摘　　要：目的评价经颞下方Ahmed青光眼阀(Ahmed glaucoma valve,AGV)植入术治疗硅油填充术后继发性青光眼的远期临床疗效。方法回顾性研究27例(27眼)经颞下方植入AGV术后患者,其中硅油填充术后继发性青光眼患者(硅油组)11例(11眼),无硅油填充患者(对照组)16例(16眼)。比较2组术后眼压、术后抗青光眼药物数量、成功率及并发症。结果硅油组和对照组AGV植入术前眼压分别为(42.09±4.91)mmHg(1kPa=7.5mmHg)和(41.63±5.46)mmHg,差异无统计学意义(P=0.823);术前使用抗青光眼药物数量分别为(3.45±0.52)种和(3.06±0.77)种,差异无统计学意义(P=0.155)。硅油组术后最后一次随访眼压(26.55±3.70)mmHg,与术前比较,差异有显著统计学意义(P=0.000);术后使用抗青光眼药物数量(1.55±1.51)种,与术前比较,差异有显著统计学意义(P=0.003);对照组术后最后一次随访眼压(20.25±6.39)mmHg,与术前比较,差异有统计学意义(P=0.000);术后使用抗青光眼药物数量(1.38±1.46)种,与术前比较,差异有统计学意义(P=0.002)。术后最后一次随访眼压比较,硅油组高于对照组,差异有显著统计学意义(P=0.007),但是两组使用抗青光眼药物数量差异无统计学意义(P=0.771)。术后6个月、12个月、18个月、24个月的累积成功率:硅油组分别为64%、36%、18%、0%;对照组为93%、71%、53%、18%;2组比较差异有统计学意义(P=0.017)。硅油组和对照组术后发生并发症的眼数分别为5眼和6眼。结论采用颞下方植入AGV治疗硅油填充术后的继发性青光眼是比较有效和相对安全的治疗方法,但是眼内硅油的存在增加了手术失败的风险。Objective To evaluate the long-term clinical results of inferotempo- ral Ahmed glaucoma valve （AGV） implantation on glaucoma eyes containing silicone oil, compared with those without silicone oil. Methods This was a retrospective stud- y,27 eyes in 27 patients were treated with inferotemporal AGV implantation, including ll eyes （ll cases） with silicone oil endotamponade （silicone oil group） and 16 eyes （ 16 cases） without silicone oil endotamponade （ control group）. The postoperative in- traocular pressure,anti-glaucoma drug number, successful.rate and complication were compared between two groups. Results Preoperatively, IOP in silicone oil group and control group were （42.09 ± 4.91 ） mmHg （ 1 kPa = 7.5 mmHg） and （41.63 -± 5.45 ） mm- Hg,respectively,there was no statistical difference（P = 0.823 ） ;The number of medications in silicone oil group and control group were 3.45 ± 0.52 and 3.05 ± 0.77, respectively, there was no statistical difference （P = 0.155 ）. At the last postoperative follow-up IOP in silicone oil group and control group were （26.55 ± 3.70） mmHg and （ 20.25 ± 6.39 ） mmHg, respectively, there were significant differences compared with pre-operation （ both P = 0. 000 ）, significant difference between two groups （ P = 0. 007） ;The number of medications in silicone oil group and control group were 1.55 ± 1.51 and 1.38 ± 1.46 ,respectively, there were significant differences compared with pre-operation （P = 0. 003,0. 002 ）, no statistical difference between two groups （P = 0.771 ）. The cumulative probability of success by life-table analysis was 64% at 6 months, 36% at 1 year, 18% at 18 months,and 0 at 2 years in silicone oil group,and 93% at 6 months,71% at 1 year,53% at 18 months,18% at 2 years in control group ,there was statistical difference between two groups（P=0.017 ）. Complications appeared in 5 eyes of silicone oil group and 6 eyes of control group. Conclusion The inferotemporal AGV implantation is effective and relat

关 键 词：AHMED青光眼阀植入术 硅油 眼压 难治性青光眼 

分 类 号：R775[医药卫生—眼科]