Ahmed青光眼引流阀植入术后处理引流盘纤维包裹的研究进展

Research progress on the treatment of fiber wrapping of drainage tray after Ahmed glaucoma drainage valve operation

Ahmed青光眼引流阀植入术作为难治性青光眼的主要治疗方案,能很大程度控制眼压,且疗效和预后均优于常规滤过性手术。但是远期引流盘周围被纤维包裹后会阻塞房水流出,引起术后高眼压,导致手术失败。因此,解决引流盘纤维包裹能很大程度地提高青光眼阀植入术后远期成功率,这也是目前的研究热点。目前临床上主要采用术前预防及术后二次操作对纤维包裹进行干预,但长期效果欠佳。本文就青光眼引流阀纤维包裹发生的组织病理学及分子机制、临床目前解决方案、前沿研究进展以及对Ahmed青光眼阀门的材料改造的探索进行综述。

Ahmed glaucoma valve implantation,as the main treatment option for refractory glaucoma,can control intraocular pressure(IOP)to a large extent.And its efficacy and prognosis are superior to those of conventional filtration surgery.IOP is well-controlled in the early postoperative stages.However,long-term fibrosis of encapsulated bleb inhibits fluid exchange and causes elevated IOP,leading to surgical failure.Therefore,treating fibrosis of encapsulated bleb can improve the long-term success rate after glaucoma valve implantation,which is also a research hotspot.Currently,the main clinical interventions are preoperative prophylaxis and postoperative secondary operations for fiber wrapping,but its long-term efficacy is not satisfactory.This article reviews the occurrence,histopathology and molecular mechanism of fibrous encapsulation,treatment in a clinical setting,cutting-edge research progress,and exploration on material modification of Ahmed glaucoma valve.