Ahmed青光眼引流阀治疗新生血管性青光眼的临床疗效

Clinical efficacy of Ahmed glaucoma valve implantation in neovascular glaucoma

目的:评价Ahmed青光眼引流阀治疗新生血管性青光眼的临床效果。方法:回顾性病例研究。收集2011-01/2012-12住院行Ahmed青光眼引流阀植入术治疗的28例28眼新生血管性青光眼患者临床资料,进行回顾性分析。患者随访时间为术后1d;1wk;1,3,6mo及之后的每6mo随访1次。随访内容主要包括患者术后眼压、最佳矫正视力、应用抗青光眼药物种类数及并发症等。术后不同时间点的眼压比较采用重复测量资料的方差分析,手术前后应用抗青光眼药物种类数比较采用秩和检验,术前与末次随访视力比较采用等级资料秩和检验。结果:不同时间点的眼压比较差异有统计学意义(F=11.23,P<0.05)。术前平均应用抗青光眼药物4.12±0.23种,术后平均应用抗青光眼药物0.56±0.11种,手术前后比较差异有统计学意义(Z=9.224,P<0.05)。术前与末次复查视力比较,差异无统计学意义(Z=-1.922,P>0.05)。Ahmed引流阀植入术完全成功率71%,条件成功率86%。术后并发症主要包括引流盘周围包裹性囊状泡、浅前房、低眼压对症处理后眼压均可控制。结论:Ahmed青光眼引流阀植入术是新生血管性青光眼的安全、有效治疗方式之一。

AIM ： To evaluate the efficacy of Ahmed glaucoma valve implantation in neovascular glaucoma （NVG）. METHODS： This retrospective study collected a total of 28 eyes of 28 neovascular glaucoma patients who underwent Ahmed glaucoma valve implantation in our hospital from January 2011 to December 2012. Change of intraocular pressure, the best corrected visual acuity, numbers of anti-glaucoma medication and postoperative complications were followed up at ld, lwk, 1, 3, 6too, and every 6 months after surgery. Data were analyzed by repeated measures analysis of variance for comparison of intraocular pressure between different time points, rank sum test for paired nonparametric numbers of medication, and rank sum test for visual acuity between pre-operation and the last following-up. RESULTS： Compared with the pre- operation, the intraocular pressure was significant decreased after surgery at all time points （F= 11. 23, P〈 0. 05）. The numbers of anti-glaucoma medication were significant reduced from 4.12_＋0.23 of pre-operation to 0.56_＋0.11 of postoperative （Z= 9. 224, P〈0.05）. The visual acuity was not significant difference between pre-operation and the last following-up （Z=-l. 922, P〉0. 05）. At the last following-up, the complete success rate was 71%, and qualified success rate was 86%. The postoperative complications including encapsulated cystic blebs around the plate, shallow anterior chamber and low intraocular pressure were controlled with additional treatment. CONCLUSION： Ahmed glaucoma valve implantation is safe and effective in the management of neovascular glaucoma.