丝裂霉素C联合Ahmed青光眼阀植入术治疗难治性青光眼的中远期疗效

The Effects of Ahmed Valve Implantation with Adjunctive Mitomycin C for Complicated Glaucoma

目的评价丝裂霉素C（MMC）联合Ahmed青光眼阀（AGV）植入治疗难治性青光眼的中远期疗效,探讨手术并发症的预防及处理。方法采用MMC联合AGV植入术治疗难治性青光眼32例（32眼）,术后随防3～54月。结果眼压由术前（47.5±7.32）mmHg下降至（17.73±6.21）mmHg,总有效率84.38%。手术早期并发症为浅前房、低眼压,但不发生前房消失,术后7～8 d前房自动加深。中远期并发症为瞳孔欠圆、盘周过度包裹。结论MMC联合AGV植入术是目前治疗难治性青光眼较理想的手术方法,其并发症较无阀门引流物少;及时有效的术后处理将提高手术成功率。

Objective To evaluate long-term outcomes after Ahmed valve implantation with adjunctive mitomycin C （MMC） in patients with complicated glaucoma. Methods 32 patients （32 eyes） with complicated glaucoma undergoing Ahmed valve implantation with adjunctive intraoperative MMC were followed up about 3%54 months. Results The average level of final intraocular pressure （IOP） was decreased from 47.5±7.32 mmHg to 17.73±6.21 mmHg and was effective for complicated glaucoma （84.38%）. Except for disappearance of anterior chamber, shallow charmer and hypotension, were mostly observed in early postoperative complications. However in long term, . aspheric pupil and large encapsulation around Ahmed valve were mainly observed. Conclusion The adjunctive use of intraoperative MMC with Ahmed valve implantation results in high success rates. IOP was well controlled and less postoperative complications were observed in the majority of patients within the long postoperative period.