Ahmed青光眼引流阀植入术治疗新生血管性青光眼的新进展

Research progress of Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma

新生血管性青光眼（NVG）是一类以虹膜及房角新生血管形成为特征的继发性青光眼，其致盲率高，治疗棘手，目前主要的治疗策略包括视网膜缺血的治疗、药物控制眼压和手术降低眼压3个方面。虽然NVG有许多手术治疗方法，但多存在并发症，远期效果尚不能令人满意。Ahmed青光眼引流阀植入术（AGVI）因其术后浅前房、低眼压等并发症少，术后眼压控制稳定，是NVG的首选治疗方式之一，影响手术疗效的主要因素为纤维增生、新生血管再次形成等，AGVI联合抗纤维治疗及抗血管内皮生长因子（VEGF）治疗可能为NVG的治疗提供了新的途径。近年来研究表明，AGVI联合抗VEGF药物的应用能够提高手术成功率。AGVI术中联合应用抗纤维药物，如丝裂霉素C、缓释型抗纤维药物等可以改善手术预后。本文针对AGVI治疗NVG及联合抗纤维化、抗VEGF治疗的研究进展进行综述。

Neovascular glaucoma （NVG） is a kind of devastating secondary glaucoma characterized by neovascularization in iris and anterior chamber angle, which often results in loss of vision. The current standard of treatment includes retinal ablation and control of enhanced intraocular pressure with drugs and surgical therapy. There are a lot of surgical therapies of NVG,while the prognosis of these therapies are not satisfactory as most of them would be effected by different kinds of complications. Ahmed glaucoma valve implantation （AGVI） is one of the main treatments means being widely used with less postoperative complications, such as shallow anterior chamber, low intraocular pressure. Failure of AGVI mainly caused by fiber hyperplasia and neovascularization. AGVI combined with anti-fibrosis therapy and anti-vascular endothelial growth factor （VEGF） therapy might be a promising method to promote surgical outcomes. It has been shown that AGVI combined with anti-VEGF drugs can improve the success rate of surgery. Besides, some researchers found that AGVI with intraoperative application of anti-fibrosis drugs, such as mitomycin C, sustained-release anti-fibrosis drugs can improve the prognosis of surgery in neovascular glaucoma patients. The progress of research on anti-fibrosis and anti-VEGF treatment combined with Ahmed glaucoma valve implantation was discussed in this review.