Ahmed青光眼阀治疗难治性青光眼术后浅前房的预防及处理

Treatment and effective ways for precaution of shallow of anterior chamber after implantion of Ahmed glaucoma valve(AGV) for refractory glaucoma

目的探讨Ahmed青光眼阀(AGV)置入术治疗难治性青光眼术后浅前房的预防方法及治疗措施。方法对22例(22只眼)难治性青光眼患者行AGV前房置入术时前房注射粘弹剂及可吸收缝线结扎引流管,观察术后浅前房等并发症的发生率及手术效果。结果术后Ⅱ级以上浅前房的发生率为9.0%(2/22),平均随访时间(12.29±11.18)个月,最后随访眼压平均为(23.45±12.04)mmHg,不用降眼压药,6mmHg≤最后随访眼压≤21mmHg15只眼,完全成功率为54.84%,予局部应用降眼压药,眼压≤21mmHg6只眼,相对成功率为19.35%,总成功率为74.19%。结论Ahmed青光眼阀前房置入术术中应用透明质酸钠及可吸收缝线结扎引流管等综合措施,可预防术后浅前房的发生及由浅前房引起的一系列并发症。

Objective To invesigate effective ways for precaution of shallow of anterior chamber after implantation of ahmed glaucoma valve （ AGV ） to treat refractory-glaucoma. Methods In treating group, with refractory glaucoma were treated with AGV implant placement in anterior chamber with partial ligation of asilicone tube of AGV and injection visco-elastic material were performed on. The main outcome measure was the rate of early postoperative shallow anterior chamber and the postoperative intraocular pressure （ IOP ）. Results Ⅱ level and above the incidence of shallow anterior chamber： 2 / 22, with an average follow-up time （ 12.29 ± 11.18 ） months, an average of the last follow-up of intraocular pressure （ 23.45 ±12.04） mm Hg, no intraocular pressure lowering drugs, 6 mm Hg ≤ the final follow-up of intraocular pressure ≤21 mm Hg15 patients, complete success rate was 54.84%, to the local application of intraocular pressure lowering drugs, intraocular pressure ≤ 21 mm Hg6 cases, the relative success rate of 19.35 percent, 74.19 percent for the power assembly. Conclusion The technique including partial ligation of silicone tube of AGV and injection visco-elastic material with refractory glaucoma. Undergoing AGV implantion may prevent early postoperative shallow anterior chamber and other complicatious induced from shallow anterior chamber.