摘要
目的评价Ａｈｍｅｄ青光眼阀植入术治疗难治性青光眼的近期和中期疗效，探讨术中、术后并发症及预防。方法对２０例难治性青光眼施行颞上象限前房到赤道部区域的Ａｈｍｅｄ青光眼阀植入术。其中新生血管性青光眼９例，无晶体或人工晶体植入术后青光眼７例，先天性青光眼３例，原发性慢性闭角型青光眼１例。结果术后１个月，眼压≤２．８ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）者１５例，总成功率为７５．０％；其中新生血管性青光眼成功率为５５．６％，其它类型青光眼成功率为９０．９％。８５．０％的患者视力提高或不变；随访６个月以上者１２例，总成功率为５８．３％；其中新生血管性青光眼成功率为４０．０％，而其它类型青光眼成功率为７１．４％。并发症包括短暂性前房出血，术后早期低眼压，引流管内、外口阻塞，引流管接触晶体或角膜，引流管外露，渗出性脉络膜脱离，植入盘脱出。结论尽管Ａｈｍｅｄ青光眼阀植入术存在一些不容忽视的并发症，但仍不失为治疗难治性青光眼的一种有效方法。
Objective To evaluate the shortterm and longterm efficacy of Ahmed valve implantation for refractory glaucoma and discuss its intraoperative and postoperative complications and management. Methods 20 cases of refractory glaucoma underwent Ahmed valve implantation, including 9 cases of neovascular glaucoma, 7 cases of aphakic or pseudophakic glaucoma, 3 cases of congenital glaucoma and one primary chronic angleclosure glaucoma. Results One month postoperatively, the intraocular pressure (IOP) was less than or equal to 2.8 kPa (1 kPa=7.5 mmHg) in fifteen cases, with a total success rate of 75%. For cases with neovascular glaucoma, the success rate was 55.6%, while for the others, the rate was 90.9%. After six months of followup for 12 patients, the total success rate was 58.3%, for neovascular glaucomas and other glaucomas, the rate was 40.0% and 71.4%, respectively. The complications included transient hyphema, early postoperative hypotony, obstruction of the tube tip, tube touch to lens or cornea, tube exposure, exudative choroidal detachment and dropout of the plate. Conclusion Ahmed valve implantation is an effective method in the management of refractory glaucoma in spite of its unnegligible complications.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
1997年第6期417-420,共4页
Chinese Journal of Ophthalmology
