玻切术后继发性青光眼Ahmed阀玻璃体腔植入与前房植入效果比较  

Comparison of the efficacy between Ahmed glaucoma valve implantation in vitreous cavity and in anterior chamber for the treatment of secondary glaucoma after vitrectomy

作　　者：赵英迪 解正高 朱俊[1] Zhao Yingdi;Jie Zhenggao;Zhu Jun(Department of Ophthalmology,Northern Jiangsu People’s Hospital,Yangzhou 225001,China;Department of Ophthalmology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]江苏省苏北人民医院眼科,扬州225001 [2]南京大学医学院附属鼓楼医院眼科,南京210008

出　　处：《中华眼外伤职业眼病杂志》2021年第1期34-38,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较Ahmed青光眼阀玻璃体腔植入和前房植入治疗玻璃体切除术后继发性青光眼的效果。方法回顾性分析江苏省苏北人民医院眼科2015年1月至2019年10月玻璃体切除术后继发性青光眼23例(23眼)的临床资料。所有患者分别采用两种方法行Ahmed青光眼阀植入术。前房组12例(12眼),经角膜缘植入前房;玻璃体腔组11例(11眼),经睫状体平坦部植入玻璃体腔。术后随访4~32个月,比较两组疗效。结果玻璃体腔组手术耗时为(31.88±5.30)分钟,少于前房组的(45.63±8.63)分钟(t=3.838,P=0.002)。前房组成功率为75.00%(9/12),低于玻璃体腔组81.81%(9/11)。两组术后眼压均较术前降低(均P<0.05),但两组之间术后各时间点差异均无统计学意义(均P>0.05)。两组均未出现严重并发症。结论玻璃体腔植入与前房植入Ahmed青光眼阀均可安全有效地控制玻切术后继发性青光眼,而玻璃体腔植入手术操作较为简便省时。Objective To compare the efficacy of two methods of Ahmed glaucoma valve implantation’in vitreous cavity and in anterior chamber’for the treatment of secondary glaucoma after vitrectomy.Methods The clinical data of 23 eyes of 23 patients with secondary glaucoma after vitrectomy from Jan.2015 to Oct.2019 in Northern Jiangsu People’s Hospital were retrospectively analyzed.All cases underwent Ahmed glaucoma valve implantation with two methods.In anterior chamber group,12 eyes of 12 cases were treated with drainage tube inserted through limbus.In vitreous cavity group,11 eyes of 11 cases were treated with drainage tube inserted into vitreous cavity through pars plana.The patients were followed up for 4-32 months and the efficacy of the two groups were compared.Results The operative time of vitreous cavity group was(31.88±5.30)minutes,which was less than(45.63±8.63)minutes of anterior chamber group(t=3.838,P=0.002).The success rate in the anterior chamber group and the vitreous group was 75.00%(9/12)and 81.81%(9/11),respectively.The post-operative IOP were significantly lower than the pre-operative IOP in both groups(all P<0.05).There was no significant difference between the two groups at each time points(all P>0.05).No serious complication occurred in two groups.Conclusion Both Ahmed glaucoma valve implanted in vitreous cavity and in anterior chamber can control the secondary glaucoma after vitrectomy safely and effectively,but the former is more convenient and time-saving.

关 键 词：玻璃体切除术 青光眼 继发性 植入 青光眼阀 Ahmed 前房 玻璃体腔 

分 类 号：R779.6[医药卫生—眼科]