摘要
目的:探讨引流植入物手术治疗难治性青光眼的有效性和安全性。方法:采用Ahmed青光眼阀引流植入物(AhmedGlaucomaValve,AGV)治疗难治性青光眼41例44只眼,其中20只深前房眼选择AGV植入术,24只浅前房眼或前房有玻璃体者选择AGV植入联合晶体和或前玻璃体切除术,所有病例术中均应用丝裂霉素C(MitomycinC,MMC),术后平均随访15个月。结果:术后末次随访时眼压为148±843mmHg,比术前降低702%,P<0001;术后眼压在8～20mmHg之间者41只眼,手术成功率为932%;术后视力提高二行以上者21只眼(477%)。AGV联合手术与单纯AGV植入术比较,前者一次手术成功率875%,前房延缓形成42%,引流管堵塞42%;而后者分别为50%、40%及30%。结论:AGV植入联合前玻璃体切除术和或晶体摘除,可提高一次手术成功率,减少术后并发症;手术同期可行人工晶体缝合固定,并能处理其他伴随病变,不仅减少多次手术给患者造成的痛苦,而且在控制眼压的同时挽救了一定的视力。
Purpose:To probe into the effect and security of the treatment of refractory glaucoma with Ahmed Glaucoma Valve Implantation.Method:44 eyes of 41 patients suffering from refractory glaucoma were treated with Ahmed Glaucoma Valve implant surgery and all of above with MMC.20 eyes with deep chamber were treated by Ahmed Glaucoma Valve implant surgery,24 eyes with shallow chamber or vitreous in chamber were combined with vitrectomy and/or len extraction.The mean follow up was 15 months.Results:After surgery,the mean IOP was 14 8±8 43mmHg.Compared with before surgery,the IOP was lowered by 70 2%,P<0 001;41 eyes ranged 8 to 20mmHg(success rate 93 2%),and 21 eyes had increased visual acuity(47 7%).Applying to Ahmed Glaucoma Valve implant surgery combined with vitrectomy,the first success rate was 87 5%,the block of the valve tube and shallow anterior chamber was 4 2%.Conclusion:The combination surgry may increase the rate of success in first surgery,and decrease the complications after surgery;in the same procedure,the IOL can be implanted and other diseases were treated.
出处
《中国实用眼科杂志》
CSCD
2000年第2期89-92,共4页
Chinese Journal of Practical Ophthalmology
