房水引流物植入术治疗玻璃体手术后的难治性青光眼

Glaucoma valve devices for refractory glaucoma following vitrectomy

目的 评价房水引流物植入术治疗玻璃体手术后难治性青光眼的效果。方法 对 15例 (16只眼 )眼部条件极差 ,经硅油取出和 (或 )最大剂量药物治疗不能控制眼压的玻璃体手术后继发性青光眼患者 ,行房水引流物植入术。其中 13只眼植入Ahmed减压阀 ,3只眼植入Krupin减压阀。结果 患者平均随访 18 5个月。手术成功率 :3个月时为 76 9% ,6个月时为 70 0 % ,1年以上为6 6 7%。术后常见并发症包括短暂性前房出血、早期低眼压、脉络膜脱离、前房延缓形成及引流口阻塞等。结论 房水引流物植入术是治疗玻璃体手术后难治性青光眼的一种安全、有效方法。

Objective To evaluate the surgical effectiveness of glaucoma valve devices for refractory glaucoma following vitrectomy surgery Methods Sixteen eyes of 15 patients suffering from secondary glaucoma following vitrectomy were treated with glaucoma valve implantation, all of the eyes were in critical condition, and the intraocular pressure failed to control after the silicone oil removal and/or with glaucoma medication Among them, 13 eyes underwent Ahmed valve implantation and 3 eyes underwent Krupin disk implantation Results The mean follow up was 18 5 months The total success rate was 76 9% at 3 months, 70 0% at 6 months and 66 7% at one year or longer The postoperative complications included transient hyphema, early postoperative hypotony, choroidal detachment, shallow anterior chamber and obstruction of the tube tip Conclusion The glaucoma valve device is a safe and effective method for refractory glaucoma following vitrectomy, especially for the patients who have a certain level of visual acuity