Ahmed青光眼引流阀睫状沟植入治疗人工晶状体眼青光眼

Ahmed glaucoma valve implanting through the ciliary sulcus in the treatment of intraocular lens glaucoma

目的:评价Ahmed青光眼引流阀睫状沟植入术治疗人工晶状体眼青光眼的疗效。方法:采用回顾性病例系列研究。收集2020-02/2022-02柳州市红十字会医院收治的人工晶状体眼青光眼患者18例18眼的临床资料,所有患者均行Ahmed青光眼引流阀睫状沟植入术。观察术前,术后1、3、6、12mo的视力、眼压、角膜内皮细胞密度、角膜内皮细胞丢失率及并发症发生情况。结果:术前平均眼压为43.41±5.33mmHg,术后1、3、6、12mo的平均眼压分别为12.11±3.26、13.82±4.12、13.54±3.83、15.80±4.35mmHg,术后各随访点平均眼压较术前明显下降(F=203.40,P<0.01)。术后各时间点角膜内皮细胞密度较术前降低(F=6.18,P<0.01),但术后1、3、6、12mo各时间点角膜内皮细胞密度及丢失率均无差异(P>0.05),总手术成功率为83%。结论:青光眼引流阀睫状沟植入术治疗人工晶状体眼青光眼安全有效,对角膜内皮细胞损伤小,术后角膜内皮细胞不随时间的变化减少。

AIM:To evaluate the efficacy of Ahmed glaucoma valve implanting through the ciliary sulcus in the treatment of intraocular lens(IOL)glaucoma.METHODS:Retrospective case series study.The clinical data of 18 patients(18 eyes)with IOL glaucoma from February 2020 to February 2022 in Liuzhou Red Cross Hospital were collected.All patients underwent Ahmed glaucoma valve implanting through the ciliary sulcus.The visual acuity,intraocular pressure,corneal endothelial cell density,corneal endothelial cell loss rate and complications were observed before operation and 1,3,6 and 12mo after operation.RESULTS:The mean intraocular pressure before operation was 43.41±5.33 mmHg.The mean intraocular pressure at 1,3,6 and 12mo after operation were 12.11±3.26,13.82±4.12,13.54±3.83 and 15.80±4.35 mmHg respectively.The mean intraocular pressure at each follow-up point after operation was significantly lower than that before operation(F=203.40,P<0.01).The corneal endothelial cell density at each time point after surgery was lower than that before surgery(F=6.18,P<0.01),but there were no significantly differences in the density and loss rate of corneal endothelial cell at 1,3,6 and 12mo after surgery(P>0.05).Furthermore,the overall surgery success rate was 83%.CONCLUSIONS:Ahmed glaucoma valve implanting through the ciliary sulcus is safe and effective in the treatment of IOL glaucoma,and the damage to corneal endothelial cells is mild.The corneal endothelial cells density doesn’t decrease with time after surgery.