引流阀睫状体平坦部植入术治疗晶状体玻璃体切除术后继发青光眼  

A clinical study on Ahmed glaucoma valve implantation through pars plana in treating of secondary glaucoma after lensectomy and vitrectomy

作　　者：牛耘丽[1] 荣翱[1] 

机构地区：[1]同济大学附属同济医院眼科,上海200065

出　　处：《中华眼外伤职业眼病杂志》2016年第6期409-412,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价Ahmed青光眼引流阀睫状体平坦部植入术治疗晶状体玻璃体切除术后继发青光眼的效果及其安全性。方法对晶状体玻璃体切除术后继发性青光眼13例（13只眼）行Ahmed青光眼引流阀睫状体平坦部植入术。术后随访6个月。对手术前后视力、眼压、使用抗青光眼药物的数量，以及术中术后并发症进行分析。结果术后6个月，视力提高者9例（69．23％），视力不变4例（30．77％）。术前平均眼压为（40．6±7．7）mmHg（1mmHg=0．133kPa），术后1d、1周、2周、1个月、3个月和6个月平均眼压分别为（13．6±3．37）mmHg、（17．6±4．5）mmHg、（16．54±2．3）mm—Hg、（18．46±1．66）mmHg、（16．61±1．92）mmHg及（15．69±3．83）mmHg，均显著低于术前眼压，差异均有统计学意义（t=9．65—16．23，P〈0．01）。术前应用抗青光眼药物的平均数量为（2．92±0．64）种，术后减少至（1．23±0．93）种，差异具有统计学意义（t=5．92，P=0．0001）。并发症包括短暂性前房积血、早期低眼压、脉络膜脱离及引流管内口阻塞，但均自行恢复或经对症处理后恢复正常。结论对于晶状体玻璃体切除术后药物无法控制眼压的患者，Ahmed青光眼引流阀睫状体平坦部植入是一种安全有效、并发症少的手术方式。Objective To evaluate the eflqcacy and safety of Ahmed glaucoma valve （AGV） implantation through pars plana for secondary glaucoma following lensectomy and vitrectomy surgery. Methods Thirteen eyes of 13 patients who had been diagnosed as secondary glaucoma after lensectomy and vitreetomy were selected in this study. All cases were treated with AGV implantation through pars plana with follow-up of 6 months. The intraocular pressure （ lOP）, complications, number of antiglaucoma medications applied and best-corrected visual acuity （BCVA） were evaluated during the followe-up. Results The BCVA of 9 eyes were improved, the visual acuities of 4 eyes were constant postopearatively after 6 months. The mean lOP was （40.6 ± 7.7 ） mmHg preoperatively, （ 13.6 ± 3.37 ） mmHg at 1 day after surgery, （ 17.6 ± 4.5 ） mmHg in 1 week, （ 16.54 ± 2.3 ） mmHg in 2 weeks, （ 18.46 ± 1.66） mmHg in 1 month, （ 16.61 ± 1.92）mmHg in 3 months, and （15.69 ±3. 83）mmHg in 6 months（1 mmHg =0. 133 kPa）. The postoperative lOP descended noticeably（ t = 9.65 ± 16.23, P 〈 0. 05 ）. The mean number of antiglaucoma medieations applied dreaseed from （2.92 ±0.64） kinds preoperatively to （ 1.23 ±0. 93） kinds at the last follow-up （ t = 5.92,P = 0.0001 ）. The most common complications occurred were transient hyphema, early postoperative hyponoty, detachment of choroid and drainage tube blocking. Conclusion AGV implantation through pars plana is effective and safe in the management of secondary glaucoma following lenseetomy and vitrectomy surgery.

关 键 词：青光眼引流阀 Ahmed 晶状体切除术 玻璃体切除术 青光眼 继发性 

分 类 号：R779.6[医药卫生—眼科]