摘要
目的探讨Ahmed青光眼阀植入治疗外伤性青光眼的疗效及治疗体会。方法回顾性分析2010年1月至2013年12月在潍坊眼科医院应用Ahmed青光眼阀植入术治疗外伤性青光眼21例(22只眼),年龄22~75岁,男16例,女5例,术后随访6—50个月,平均29.5个月。分析术中及术后并发症、视力、局部用药情况,比较术前术后及随访期眼压。结果术后1周、术后1月、术后3月、术后6月、术后1年、术后2年的平均眼压为(12.55±3.62)、(18.86±9.28)、(17.77±3.47)、(17.36±2.62)、(18.17±1.27)、(19.22±3.68)mmHg,均较术前平均眼压(49.14±11.12)mmHg为低,差异有统计学意义(P〈0.01)。术后1周,手术成功率为100%,手术后1个月,手术成功率为81.8%,手术后3月,手术总成功率为90.9%,术后6个月总成功率95.5%,术后1年手术成功率95.5%,术后2年手术成功率89.5%。术后—个月始有病例使用降眼压药物,术后1月、术后3月、术后6月、术后1年、术后2年平均使用降眼压药物数分别为(0.41±0.91)、(0.27±0.63)、(0.23±0.61)、(0.58±1.08)、(0.59±1.11)种,较术前平均使用药物数量(3.09±1.15)种明显少,差异有统计学意义(P〈0.05)。术后早期常见并发症包括前房积血1例、短暂浅前房1例、短暂高眼压2例,脉络膜脱离1例。结论Ahmed青光眼阀植入是治疗外伤性青光眼的确切有效治疗方法,术中透照技术确定进入前房位置是手术的关键点。
Objective To evaluate the clinical efficacy and treatment experience of Ahmed glaucoma valve (AGV) implantation for post-traumatic glaucoma. Methods Retrospective medical records of 21 patients (22 eyes) with post-traumatic glaucoma which performed AGV implantation were analyzed. Those aged 22 to 75, 16 cases of male, female in 5 cases, postoperative follow-up 6-50 months, and an average of 29.5 months. Complications, visual acuity (VA), intraocular pressure (lOP) and anti-glaucoma medications were observed. Results The IOP was reduced from a mean of (49.14 ± 11.12)mmHg preoperation to (11.68 ± 3.97)mmHg, (18.86 ± 9.28)mmHg, (17.77 ± 3.47)mmHg, (17.36±2.62)mmHg, (18.17±1.27)mmHg and (19.22±3.68)mmHg post-operation for one week, one month, 3 months, 6 months, one year and two years respectively. The probability of success rate was 100%, 81.8%, 90.9%, 95.5%, 95.5% and 89.5%. The early major complications included hyphema (1 eye), shallow anterior chamber (1 eye), transient ocular hypertension (2 eyes), and choroid detachment (1 eye). Conclusions The Ahmed glaucoma valve (AGV) implantation combined Mitomycin (MMC), anterior chamber filled with Viscoelastic and allogeneic sclera covered tube. These applications reduced the early major complications. Ahmed glaucoma valve (AGV) implantation is an effective method for traumatic glaucoma.
出处
《中国实用眼科杂志》
2016年第7期726-729,共4页
Chinese Journal of Practical Ophthalmology