Ahmed青光眼阀植入术联合前部玻璃体切除治疗新生血管性青光眼

Ahmed glaucoma valve implantation combined with anterior vitrectomy for treatment of neovascular glaucoma

目的:观察Ahmed青光眼阀(ahmed glaucoma valve,AGV)植入术联合前部玻璃体切除治疗新生血管性青光眼的疗效。方法:对观察组32例32眼新生血管性青光眼患者行AGV植入术联合前部玻璃体切除,观察术后浅前房等早期并发症的发生率及手术效果,并与对照组22例24眼按常规方法行AGV植入术者进行比较。结果:术后前房延缓形成的发生率:观察组为3/32(9.4%),对照组为8/24(33.3%),两组差异有统计学意义(χ2=4.987,P=0.026),术后早期低眼压:观察组为10/32(31.3%),对照组为14/24(58.3%),两组差异有统计学意义(χ2=4.108,P=0.043),引流管阻塞发生率两组差异均无统计学意义。所有病例术后1mo时眼压≤2.8kPa者:对照组15/24(62.5%),观察组28/32(87.5%)。随访6mo,观察组总成功率17/32(53.1%),对照组总成功率13/24(54.2%),两组差异无统计学意义。结论:AGV植入术联合前部玻璃体切除治疗新生血管性青光眼操作简单,并发症少,疗效满意,是值得推荐的治疗方法。

AIM： To observe the clinical effect of Ahmed glaucoma valve （AGV） implantation combined with anterior vitrectomy for treatment of neovascular glaucoma（NVC）. METHODS, In treating group, 32 eyes of 32 patients with NVG were treated with AGV implantation combined with anterior vitrectomy and conventional AGV implantation were performed in 24 eyes of 22 patients who were taken as control group. The main measure outcomes were the rate of early postoperative complications and the postoperative intraocular pressure （IOP）. And the outcomes were compared between the two groups.RESULTS：Early postoperative shallow anterior chamber occurred in 3 eyes in the treating group and in 8 eyes in control group（X^2 =4.987, P = 0.026）. Early postoperative hypotomy occurred in 10 eyes in the treating group and in 14 eyes in control grouP（X^2=4.108, P = 0.043）. At the first month of follow-up, the operation succeeded in 28 eyes （87.5%） in the treating group, and in 15 eyes （62.5%） in the control group. At the 6th month of follow-up, the operation succeeded in 17 eyes （ 53.1% ） in the treating group and in 13 eyes （ 54.2% ） in the control group. And the difference was not significant. CONCLUSION： AGV implantation combined with anterior vitrectomy is a simple, safe and effective therapy for the treatment of NVG.