后房植入Ahmed引流管治疗伴浅前房的人工晶状体眼性青光眼

Ahmed glaucoma valve implant insertion in the posterior chamber stdcus for pseudophakic glaucoma with shallow anterior chamber

目的 研究后房植入Ahmed引流管对术前伴浅前房人工晶状体眼的难治性青光眼的手术效果及安全性.方法 取5例（6只眼）入工晶状体眼性青光眼患者行Ahmed青光眼瓣膜阀植入,因前房较浅,术中将引流管植入后房,观察术后眼压控制情况及术中术后并发症,随访6～14个月.结果 术后6个月时,患者眼压平均为（17.8±1.8）mmHg,其中1例患者术后3周时眼压升高,经超声生物显微镜检查发现引流管退缩至巩膜内,二次手术后眼压恢复正常.1例患者术后4个月出现玻璃体阻塞引流管.术中及术后未见其他并发症发生.结论 对于术前发现浅前房的人工晶状体眼性青光眼者,术中将引流管植入后房是一种较为安全有效地手术方式.

Objective To observe the surgical effectiveness and safety of Ahmed glaucoma valve （AGV） implant insertion in the posterior chamber sulcus for pseudophakic glaucoma with shallow anterior chamber preoperative. Methods The medical records of 5 patients （6 eyes） with pseudophakia accompanied shallow anterior chamber who underwent insertion of an Ahmed valve with the silicone tube placed in the posterior chamber sulcus were retrospectively reviewed. The postoperative IOP and surgical complications were observed with a follow-up of 6-14months. Results The mean IOP was （17.8± 1.8） mmHg at 6 months postoperatively. One patient presented a high pressure at 3 weeks after the operation and the silicone tube draw back to the sclera stroma were found by ultrasound biomicroscopy （UBM） and the IOP was normal after re-operative. The silicone tube of another patient was blocked by vitreous at 4 months postoperatively. No other complications were observed during surgery or follow-up. Conclusions Placement of the silicone tube in the posterior chamber is an effective and safe alternative technique for pseudophakic glaucoma with shallow anterior chamber.