Ahmed青光眼阀植入术治疗青少年难治性青光眼疗效观察  

Clinical observation on Ahmed glaucoma valve implantation for teenagers with refractory glaucoma

作　　者：宋东道 唐丽[1] 林芬明 

机构地区：[1]中国四川省资阳市人民医院眼科,641300 [2]中国广东省湛江市奥理德眼科医院眼科,524000

出　　处：《国际眼科杂志》2016年第6期1153-1155,共3页International Eye Science

摘　　要：目的:研究Ahmed青光眼阀(AGV)植入术治疗青少年难治性青光眼的临床效果。方法:选取2012-10/2014-10期间在我院眼科进行Ahmed青光眼阀植入术的青少年难治性青光眼患者27例27眼,随访12mo。观察手术成功情况,术后眼压、视力以及并发症等。结果:本组试验手术成功率85%。经过随访数据统计27例患者平均眼压由术前48.3±8.3mmH g下降到21.4±8.1mmHg,差异具有统计学意义(P<0.05);视野缺损:术前平均为-23.7±4.1d B,术后12mo-27.5±4.7d B,平均下降3.9d B,差异具有统计学意义(P<0.05)。视力提高和不变者占85%。术后早期并发症:浅前房5眼(19%),一过性高眼压3眼(11%),前房出血4眼(15%),引流管内口阻塞1眼(4%),前房硅胶管位置欠佳1眼(4%),未出现复视、引流管侵蚀与外露、引流盘脱出、脉络膜脱离、巩膜植片发生免疫排斥反应等并发症。术后中远期并发症:瞳孔欠圆8眼(30%),后部盘周包裹3眼(11%),并未出现因单纯植入引流阀而导致角膜变性的严重并发症。结论:Ahmed青光眼阀植入术具有成功率高、手术操作简单、并发症少等特点,是治疗难治性青少年青光眼有效手段。AIM ： To observe the clinical effect of Ahmed glaucoma valve（ AGV） im plantation for teenagers with refractory glaucom a. METHODS： Twenty-seven patients（ 27 eyes） with refractory glaucom a were treated with AGV im plantation in our hospital from October 2012 to October 2014. The patients were followed up for 12 mo. The success rate of the operation, postoperative intraocular pressure, the best corrected visual acuity, as well as com plications were recorded.RESULTS： The success rate of the operation was 85%.The intraocular pressure of the 27 patients decreased from 48. 3 ± 8. 3m m Hg before operations to 21. 4 ±8. 1m mHg（ P0. 05）. Visual field defect was-23. 7±4. 1d B before operations,-27. 5 ± 4. 7d B at 12 m o after operations,and the difference was statistically significant（ P 0. 05）. There was 85% patients with improved or unchanged vision. Early postoperative com plications included shallowanterior cham ber（ 5 eyes, 19%）,transient high intraocular pressure（ 3 eyes,11%） and anterior cham ber hem orrhage（ 4 eyes,15%）,drainage tube obstruction（ 1 eye,4%）,anterior cham ber silicone tube in poor position（ 1 eye, 4%）. There was no am biopia,drainage erosion and exposed,plate leaked out,choroidal detachm ent, im m une rejection of graft and other com plications. Long-term com plications included dyscoria（ 8 eyes,30%）,the back of the platepacked（ 3 eyes,11%）.CONCLUSION： AGV implantation is characterized by a high success rate,sim ple operation,less com plications and is an effective treatm ent for refractory glaucom a in adolescents.

关 键 词：AHMED青光眼阀 难治性青光眼 临床疗效 并发症 

分 类 号：R779.6[医药卫生—眼科]