Ahmed青光眼阀盘周纤维包裹二次手术后的临床分析

Clinical analysis of the resection of scar surrounding Ahmed glaucoma valve

目的分析Ahmed青光眼阀盘周纤维包裹二次手术切除后的效果和并发症。方法回顾分析在我院行全视网膜冷凝后Ahmed青光眼阀植入后因Ahmed阀的盘和引流管周围形成包裹、眼压超过30mmHg导致手术失败的患者共11例，进行二次纤维包裹切除后，分析其眼压、视力的变化和发生并发症的原因。结果11例患者术后进行1～12月的随访，远期成功率为72．7％。术前和术后眼压平均为（40．72±9．05）mmHg和（17．36±8．09）mmHg，术后较术前显著下降（t=6．38，P〈0．001）。主要并发症为Ahmed阀盘和引流管的暴露。结论二次选择性的瘢痕切除辅以抗增殖药物的应用，能够进一步提高Ahmed青光眼阀植入术的成功率。

Objective To analyze the outcome, and complications of resection of scar at the second time after Ahmed glaucoma valve implautation. Methods Eleven cases previously accepted a pan-retina coagulation and Ahmed glaucoma valve implantation with a intraocular pressure （IOP） rise higher than 30 mmHg during follow-up, underwent a scar resection operation the second time. The IOP, visual acuity and causes of comphcations were retrospectively reviewed. Results The 1 to 12 months long term success rate is 72.7% with the IOP decreasing from （40.72 ± 9.05）mmHg to （17.36 ± 8.09）mmHg. The main complication is exposing of Ahmed glaucoma valve due to the breakage of conjunctiva. Conclusion Selected resection of scar at the second time with accessorial anti-proliferative drug may be a nice way. to deal with the scarring and to optimize the outcome of Ahmed glaucoma valve implantation.