Dellen-like keratopathy associated with glaucoma drainage devices

To report the first case of dellen-like keratopathy with superior corneal thinning associated with implantation of glaucoma drainage devices. A 70-year-old male with a history of primary open angle glaucoma and dry eye disease underwent placement of glaucoma drainage devices with antimetabolite application in both eyes. Prior to placement, minimal refractive error was noted on manifest refraction. Several years later, the patient was referred for decreased vision and corneal irregularity. Examination showed pathologic corneal curvature, superior corneal thinning, and epithelial demarcation lines immediately anterior to the glaucoma drainage devices in both eyes. The epithelium remained intact with no evidence of limbal stem cell deficiency. Manifest refraction revealed a large change in both eyes. Topography was used to confirm the presence of irregular corneal curvature anterior to the glaucoma drainage devices. Dellen-like keratopathy with superior thinning is a rare sequela after implantation of a glaucoma drainage device that must be considered in elderly patients who undergo glaucoma surgery. It is likely related to a combination of tear film alteration related to previously large anterior blebs, antimetabolite application, and aqueous humor flow patterns around the drainage devices. Treatment should focus on lubrication.

Efficacy and safety of intravitreal ranibizumab with panretinal photocoagulation followed by trabeculectomy compared with Ahmed glaucoma valve implantation in neovascular glaucoma

AIM：To evaluate the efficacy and safety of intravitreal ranibizumab（IVR）with panretinal photocoagulation（PRP）followed by trabeculectomy compared with Ahmed glaucoma valve（AGV）implantation in neovascular glaucoma（NVG）.METHODS：This was a retrospective comparative study.We reviewed the cases of a total of 45 eyes from 45 NVG patients among which 23 eyes underwent AGV implantation and the other 22 underwent trabeculectomy. The causes of neovascular glaucoma included：diabetic retinopathy（25 eyes）,and retinal vein occlusion（20 eyes）.All patients received preoperative IVR combined with postoperative PRP. The mean best-corrected visual acuities（BCVA）were converted to the logarithms of the minimum angle of resolution（log MAR）for the statisitical analyses.Intraocular pressure（IOP）,the log MAR BCVA and surgical complications were evaluated before and after surgery.The follow-up period was 12 mo.RESULTS：A total of 39 cases showed complete regression of iris neovascularization at 7d after injection,and 6 cases showed a small amount of residual iris neovascularization. The success rates were 81.8% and 82.6% at 12 mo after trabeculectomy and AGV implantation,respectively. In the trabeculectomy group,the log MAR BCVA improved at the last follow-up in 14 eyes,remained stable in 6 eyes and decreased in 2 eyes. In 4 cases,slight hyphemas developed after trabeculectomy. A shallow anterior chamber developed in 2 cases and 2 vitreous hemorrhages. In the AGV group,the log MAR BCVA improved in 14 eyes,remained stable in 5 eyes and decreased in 4 eyes. Slight hyphemas developed in 3 cases,and a shallow anterior chamber in 3 cases. The mean postoperative IOP was significantly lower in both groups after surgery（F=545.468,P〈0.05）,and the mean postoperative log MAR BCVA was also significantly improved（F=10.964,P〈0.05）with no significant difference between two groups.CONCLUSION：It is safe and effective to treat NVG with this combined procedure,and we found similar results after IVR＋AGV implantation＋PRP and IVR＋trabeculectomy＋PRP in eyes with NVG.

Review of the Ahmed versus Baerveldt study-5-year treatment outcomes

The results from the tube versus trabeculectomy(TVT)study provided the evidence to support the use of aqueous shunt surgery and its increasing popularity in the world.The Ahmed versus Baerveldt(AVB)study,a randomized controlled study,compared the efficacy and safety between two of the most commonly used glaucoma drainage implants.A significant proportion of the participants had failed trabeculectomy,neovascular or uveitic glaucoma.The 5-year results showed that the cumulative probability for failure is significantly lower for Baerveldt compared to Ahmed group(52.3%vs.40.0%,P=0.039).The most common reason for failure was high intraocular pressure(IOP)but 4%of the Baerveldt group has refractory hypotony.Both surgeries were also effective in reducing dependency on intra-ocular pressure lowering medications but the Baerveldt group is superior in this aspect(median of 1 medication compared to 2 medications for Ahmed group).Both surgeries experienced 60-70%rate of complications but most were self-limiting.The most common long-term complication was corneal decompensation(10%).Overall,the results of the AVB study mirrored the results from the Ahmed Baerveldt Comparison(ABC)study.In conclusion,the 5-year report from the AVB study suggested that the Baerveldt tube is more appropriate for eyes which require much lower IOP such as eyes with advanced glaucoma or in young patients.The Ahmed tube would be more suitable for patients who are at risk of hypotony(such as uveitic and neovascular glaucoma)and those who require immediate IOP lowering after surgery.

Glaucoma drainage device implantation and cyclophotocoagulation in the management of refractory glaucoma after Descemet-stripping automated endothelial keratoplasty

AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC groups.Both groups showed significant IOP reduction after glaucoma surgery.The GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI group.CONCLUSION:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after DSAEK.GDI is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.

抗VEGF联合Ahmed引流阀植入治疗新生血管性青光眼的临床疗效

目的:观察玻璃体腔抗血管内皮生长因子(VEGF)注射联合Ahmed青光眼引流阀(AGV)植入对新生血管性青光眼(NVG)的疗效与安全性。方法:回顾性分析NVG病人47例(47眼)临床资料,其中25例(25眼)实施AGV植入术(AGV组),22例(22眼)行小梁切除术(小梁组)。2组病人术前均予以玻璃体腔内抗VEGF药物注射,术后完成全视网膜光凝,1年内定期随访。比较2组术后最佳矫正视力改善情况和手术前后眼内压(IOP)、抗青光眼药物使用情况及术后并发症、手术成功率。结果:抗VEGF治疗后,2组病人均获得不同程度的虹膜面新生血管消退,且IOP均较术前降低(P<0.05);术后各时点,2组IOP均较术前和抗VEGF治疗后降低(P<0.05)。2组病人间比较,各时间点IOP差异均无统计学意义(P>0.05)。2组术后最佳矫正视力改变情况差异无统计学意义(P>0.05)。2组术后应用抗青光眼药物种类均较术前明显减少(P<0.01)。2组术后并发症发生率差异无统计学意义(P>0.05)。AGV组手术成功率高于小梁组(P<0.05)。结论:抗VEGF药物玻璃体腔内注射联合AGV植入术治疗NVG安全有效。

Ahmed青光眼阀治疗难治性青光眼的作用和现状

青光眼是致盲性疾病,难治性青光眼的治疗更为棘手。青光眼房水引流物的出现,是治疗难治性青光眼的突破性进展,提高了中短期治疗成功率,同时也存在较多并发症。本文就常用的引流植入物—Ahmed青光眼阀在治疗难治性青光眼中的作用和研究现状作一综述。

Ahmed青光眼引流阀植入术治疗新生血管性青光眼对角膜内皮细胞密度及眼压的影响

目的:探究Ahmed青光眼引流阀植入术治疗新生血管性青光眼对角膜内皮细胞密度及眼压的影响。方法:选择2013-06/2016-06于我院治疗的新生血管性青光眼患者200例200眼,所有患者均采用Ahmed青光眼引流阀植入术治疗。对患者的病历资料进行回顾性分析,评价手术完成情况,记录术前、术后1wk,1mo,1a的眼压、角膜内皮细胞密度,视力、并发症发生情况。结果:所有患者中手术完全成功率为81.0%,条件成功率92.0%;手术前后视力无光感、手动~0.01、0.02~0.05、0.06~<0.10、≥0.10人数比例比较差异无统计学意义(P>0.05);术前眼压42.43±3.43mmHg,术后1wk,1mo,1a分别为13.45±2.34、15.89±2.67、16.34±2.88mmHg,差异有统计学意义(F=4570.62,P<0.001);术前角膜内皮细胞密度为2453.67±342.34个/mm^2,术后1wk,1mo,1a分别为2216.67±332.32、2087.34±326.45、1959.67±303.34个/mm^2,差异有统计学意义(F=83.42,P<0.001);术后发生前房出血20眼,低眼压13眼,引流阀阀体移位8眼,浅前房21眼。结论:Ahmed青光眼引流阀植入术治疗新生血管性青光眼能够有效控制眼压,但存在角膜内皮细胞丢失现象,能够有效保护并部分改善患者残存视力,并发症较轻且简单干预后好转,是治疗新生血管性青光眼的有效方法。

葡萄膜炎继发性青光眼与其他难治性青光眼Ahmed青光眼引流阀植入后前房反应的非随机对照研究

背景 葡萄膜炎继发性青光眼患者由于葡萄膜的炎症而导致血-房水屏障的破坏,局部手术的创伤刺激可加重炎症反应,对术眼前房炎症反应进行定量检测可监测眼部反应程度. 目的 探讨葡萄膜炎继发性青光眼患者行Ahmed青光眼引流阀植入术后前房内炎症反应是否重于其他类型的难治性青光眼.方法 采用前瞻性非随机对照的病例对照研究方法,于2011年10月至2012年7月纳入在中山大学中山眼科中心确诊的难治性青光眼29例29眼,分为葡萄膜炎继发性青光眼组（10眼）及其他类型的难治性青光眼组（19眼）,2个组间术眼术前性别、年龄、眼压及房水闪辉值等基线特征匹配.所有患者均接受Ahmed房水引流阀植入术并随访3个月,记录术前、术后1d、3d、1周、2周、1个月和3个月术眼的眼压,同时采用FC-2000激光蛋白细胞检测仪定量测定术眼的房水闪辉值,以光粒子数/ms表示.比较2个组间房水引流阀植入术后房水闪辉值的不同,对术眼手术前后眼压值变化与房水闪辉值变化的关系进行分析. 结果 葡萄膜炎继发性青光眼组术后1d、3d和1周房水闪辉值分别为[21.10 （10.50,38.58）]、[88.00（23.55,168.63）]和[29.90（8.90,65.18）]光粒子数/ms,均明显高于术前的[13.53（7.60,24.00）]光粒子数/ms,差异均有统计学意义（均P＜0.01）,术后1个月和3个月房水闪辉值分别为[6.45 （4.70,13.50）]光粒子数/ms和[8.95 （6.23,18.20）]光粒子数/ms,均低于术前值,差异均有统计学意义（均P＜0.01）;其他类型青光眼组遵循同样的趋势.术后3个月葡萄膜炎继发性青光眼组术眼房水闪辉值明显高于其他类型青光眼组,差异有统计学意义（q=-3.445,P＜0.01）.术后2个组间眼压的比较差异无统计学意义（P＞0.05）.所有患者术眼术后眼压值均逐渐下降,术前及术后1d、3d、1周、2周、1个月和3个月术眼眼压与前房闪辉值间均无明显相关性（rs =0.136,P=0.481;rs=0.019,P=0.922;rs =-0.035,P=0.858;r,=0.317,P=0.094;rs=0.034,P=0.861;rs=-0.094,P=0.628;rs=0.065,P=0.738）. 结论 FC-2000激光蛋白细胞检测仪检测证实Ahmed房水引流阀植入术可导致术眼术后早期的前房炎症反应,葡萄膜炎继发性青光眼患者术后炎症反应的恢复较缓慢,术后3个月时房水闪辉值仍高于其他类型的难治性青光眼.

Ahmed青光眼阀植入联合玻璃体切割术治疗伴玻璃体积血的新生血管性青光眼的临床观察

目的探讨Ahmed青光眼阀植入联合玻璃体切割术治疗伴有玻璃体积血新生血管性青光眼的效果。方法回顾性分析48例（52只眼）因新生血管性青光眼伴有玻璃体积血接受玻璃体切割及联合白内障摘除、全视网膜光凝及Ahmed青光眼阀植入患者的病例资料。手术前视力光感-0．3，眼压平均42mmHg（38—65mmHg）（1mmHg=0．133kPa），平均随访10个月（6—15个月）。结果手术后视力光感-0．3；眼压平均18mrnHg（10—34mmHg），显著低于手术前眼压（P＜0．05）；并发症主要包括前房及玻璃体内炎性渗出（3只眼）、玻璃体内再出血（3只眼）、术后一过性低眼压（5只眼）、1—2周内高眼压（4只眼）、手术后脉络膜上腔出血（2只眼）、视网膜脱离（1只眼）。结论玻璃体切割联合白内障摘除、全视网膜光凝及Ahmed青光眼阀植入术可能是治疗某些新生血管性青光眼伴有玻璃体积血的有效方法．

Ahmed引流阀植入治疗新生血管性青光眼临床疗效及并发症处理

目的评价Ahmed青光眼引流阀植入治疗新生血管性青光眼的临床疗效,分析其并发症及处理情况。方法 48例(48眼)新生血管性青光眼患者接受引流阀植入治疗。术后定期随访,监测患者术前与术后的眼压,观察术后并发症及处理情况。结果术前眼压为28.0~53.2mm Hg,平均(39.6±10.3)mm Hg;术后平均眼压:术后1周为(11.5±4.7)mm Hg,术后2周为(13.3±5.8)mm Hg,术后4周为(14.7±6.5)mm Hg,术后12周为(15.4±7.9)mm Hg。末次复诊平均眼压为(17.6±8.3)mm Hg,和术前相比明显降低且差异有统计学意义(P=0.03);术后视力提高29眼,视力不变15眼,视力下降2眼,视力丧失2眼。末次随访时眼压在6~21mm Hg之间有32眼(66.67%),联合降眼压药物后眼压在6~21mm Hg之间有9眼(18.75%),部分失败3眼,完全失败4眼,手术成功率为85.42%。术后并发症主要有:低眼压8眼,前房出血3眼,前房内纤维渗出膜1眼,引流盘暴露1眼,玻璃体积血2眼,早期高眼压1眼,术后中远期高眼压16眼。结论 Ahmed青光眼引流阀植入是治疗新生血管性青光眼的一种安全、有效的方法,但并发症不容忽视,需及时处理。

改良Ahmed青光眼引流阀植入术治疗难治性青光眼的临床效果

目的探讨改良Ahmed青光眼引流阀植入术治疗难治性青光眼的临床效果。方法选取2012年9月-2014年9月入住本院的30例（32眼）难治性青光眼患者作为研究对象,行改良Ahmed青光眼引流阀植入术治疗,比较手术前后的眼压、视力,记录术后并发症发生情况。结果术后1、3、12个月的平均眼压显著低于术前,差异有统计学意义（P〈0.05）。术后1、3、12个月的总成功率比较,差异无统计学意义（P〉0.05）。术后的视力水平显著优于术前,差异有统计学意义（P〈0.05）。术后并发症包括短暂性浅前房6眼、前房积血6眼和引流管后移1眼,经保守治疗均好转。结论改良Ahmed青光眼引流阀植入术能有效治疗难治性青光眼,提高手术成功率,值得临床推广应用。

难治性青光眼运用Ahmed青光眼引流阀植入术治疗的临床分析

目的研究难治性青光眼运用Ahmed青光眼引流阀植入术治疗的临床效果。方法选取12例17眼难治性青光眼患者在我院进行Ahmed青光眼引流阀植入术治疗后,对比以上患者手术前和术后视力的恢复情况、眼压的水平及并发症发生率。结果所有患者经过Ahmed青光眼引流阀植入术治疗后,术后1个月眼压为(13.5±5.3)mm Hg和术后12个月眼压为(15.2±4.4)mm Hg,低于术前,差异具有统计学意义,P<0.05;手术后10 d以内,有3眼发生前房积血(17.65%),2眼浅前房(11.76%)。结论难治性青光眼运用Ahmed青光眼引流阀植入术治疗,能改善患者的视力水平和降低眼压。

雷珠单抗联合EX-PRESS青光眼引流器植入与雷珠单抗联合Ahmed阀植入治疗新生血管性青光眼的效果研究

目的对比雷珠单抗联合EX-PRESS青光眼引流器植入与雷珠单抗联合Ahmed阀植入治疗新生血管性青光眼(NVG)的临床疗效。方法42例(42眼)新生血管性青光眼患者,根据手术方式不同分为A组(16例,16眼)和B组(26例,26眼)。A组采用雷珠单抗联合EX-PRESS青光眼引流器植入治疗,B组采用雷珠单抗联合Ahmed阀植入治疗。对比两组患者手术成功率及术后并发症发生情况,组内眼压情况。结果A组术后1 d、1周、1个月、3个月、6个月、12个月眼压均低于术前,差异有统计学意义(t=16.005、13.188、13.554、13.359、12.887、12.820,P<0.05)。B组术后1 d、1周、1个月、3个月、6个月、12个月眼压均低于术前,差异有统计学意义(t=10.212、10.898、10.004、9.644、9.025、8.839,P<0.05)。A组手术成功率为62.5%(10/16)低于B组的88.5%(23/26),差异有统计学意义(χ^(2)=3.965,P<0.05)。A组术后并发症发生率31.3%低于B组的65.4%,差异有统计学意义(χ^(2)=4.627,P<0.05)。结论雷珠单抗联合EX-PRESS青光眼引流器植入与雷珠单抗联合Ahmed阀植入治疗新生血管性青光眼均可降低眼压,雷珠单抗联合EX-PRESS青光眼引流器植入安全性优于雷珠单抗联合Ahmed阀植入,但手术成功率低于雷珠单抗联合Ahmed阀植入。

Ahmed青光眼引流阀治疗难治性青光眼疗效的Meta分析

目的:评价Ahmed青光眼引流装置植入术与传统小梁切除术(Trab)治疗难治性青光眼的疗效。方法:运用Cochrance系统评价方法,使用相关数据库检索关于Ahmed引流阀植入术与传统Trab术治疗难治性青光眼效果比较的随机对照试验(RCT)文献。观察两种手术的眼压下降幅度百分比(IOPR%)及使用与未使用抗青光眼药物达到目标IOP成功率。结果:共293例患者(293只眼)被纳入此次Meta分析,其中Ahmed组146只、Trab组147只;两组术后随访结束时IOPR%比较,差异无统计学意义[MD=-0.59,95%CI=(-7.48,6.29),P>0.05];术后1年无论是否抗青光眼药物,Trab组达到目标IOP成功率均低于Ahmed组(P<0.05)。结论:在治疗青光眼的手术中,传统Trab术与Ahmed引流阀植入术组有相似的降低IOP效果,但Ahmed引流阀植入术达到目标IOP成功率较高。

Ahmed青光眼引流阀植入治疗人工晶体眼青光眼疗效分析

目的评价Ahmed青光眼引流阀植入治疗人工晶体眼青光眼的疗效。方法回顾性分析8例(8眼)闭角型青光眼合并白内障行超声乳化白内障及人工晶体或联合房角分离术后眼压不能控制的患者,均行Ahmed青光眼引流阀植入术治疗,随访时间为术后1~36个月,随访内容主要包括患者术后视力及末次随访眼压、手术成功率及并发症情况。结果 8例患者引流阀植入术完全成功率为87.5%(7/8),部分成功率为12.5%(1/8),总成功率为100.0%(8/8)。术后视力改善3眼(37.5%),不变5眼(62.5%)。患者术后眼压为(11.25±2.92)mm Hg(1 mm Hg=0.133 k Pa),低于术前的(47.50±9.24)mm Hg,差异有统计学意义(P<0.05)。患者出现1例并发症为浅前房,保守治疗后恢复。结论 Ahmed青光眼引流阀植入术治疗人工晶体眼青光眼安全有效、成功率高、并发症少,可以作为闭角型青光眼合并白内障患者超声乳化白内障及人工晶体植入或联合房角分离术术后眼压不能控制的首选治疗方式之一。

Ahmed青光眼引流阀暴露脱出6例患者临床分析及应对措施

目的探讨Ahmed青光眼引流阀植入治疗难治性青光眼术后引流阀暴露脱出患者的临床表现及应对措施。方法回顾分析2007年4月11日—2011年9月5日间126例行Ahmed(S-3)青光眼引流阀植入术并连续随访2年以上的患者,其中6例术后出现引流阀暴露或脱出。分析其临床表现并总结应对措施。结果该次调查中青光眼引流阀植入术后发生暴露脱出的发生率为4.76%,发生时间集中在术后4个月至术后2年。临床表现主要为球结膜侵蚀及裂孔(3例)、引流盘移位(1例)、引流盘脱出(2例)。主要处理方法:球结膜修补联合异体巩膜移植术(2例)、引流阀取出联合睫状体光凝术(2例)、引流阀取出联合新引流阀植入术(1例)、原引流阀移位在植入术(1例)。结论 Ahmed青光眼引流阀植入术后暴露脱出相对少见,根据不同表现采取相应的措施仍可达到良好的降眼压效果,采取全巩膜隧道或异体巩膜覆盖可降低引流管暴露的风险。

Ahmed引流阀植入术治疗难治性青光眼的疗效

目的评价Ahmed青光眼引流阀植入术治疗难治性青光眼的疗效。方法回顾性分析本院收治的85例(94眼)难治性青光眼患者的临床资料,所有患者均行Ahmed青光眼引流阀植入术治疗,治疗后对患者进行1年的随访,对临床疗效进行评价。结果患者治疗后的视力水平、眼压水平及角膜内皮细胞计数分别为1.58±0.22、(12.7±2.5)mmHg、(1 889.2±114.5)个/mm^2,各项指标均优于治疗前,差异有统计学意义(P<0.05)。本组患者术后1年治疗成功率为95.3%。结论 Ahmed青光眼引流阀植入术治疗难治性青光眼的疗效可靠,能够有效改善患者的视力及眼压水平。

Glaucoma drainage implants

Glaucoma drainage devices have traditionally been reserved for refractory glaucoma.However,there is an increasing body of evidence to suggest the use of these implants at an earlier stage in the surgical management of glaucoma.We describe the mechanics behind their function as well as the various implants available.The implants vary in size,surface area and composition and hence the surgical implantation of these devices are described in detail.The knowledge of such devices and their potential complications is fundamental for the successful management of patients who undergo aqueous-shunt surgery.Careful patient selection and optimal postoperative management is critical to the successful patient outcomes.

Ahmed引流阀植入术治疗外伤性房角后退型青光眼的研究

目的探讨Ahmed引流阀在外伤性房角后退型青光眼手术治疗。方法回顾性研究2010年1月—2013年12月在我院接受Ahmed引流阀植入手术治疗的15例（15眼）外伤性房角后退型青光眼的临床资料,重点分析手术适应症、方法及术后疗效。结果对15例（15眼）外伤性房角后退型青光眼晚期患者采取Ahmed引流阀植入术,经手术治疗后眼压恢复到10－20mmHg者14例（93.3%）,青光眼症状消失15例。结论外伤性房角后退型青光眼,有或未经治疗后眼压仍高于40 mmHg的晚期患者,Ahmed引流阀植入术治疗是一种有效方式。

Ahmed引流阀植入联合全视网膜光凝和玻璃体腔注射Avastin治疗新生血管性青光眼

目的：评价Ahmed青光眼引流阀植入联合全视网膜光凝和玻璃体腔注射Avastin治疗新生血管性青光眼的临床疗效。方法回顾性分析我院2011年6月～2012年5月收治住院行Ahmed青光眼引流阀植入术联合全视网膜光凝和玻璃体腔注射Avastin治疗的20例（20只眼）新生血管性青光眼患者的临床资料。主要观察指标为手术前后视力、眼压、虹膜新生血管消退情况、并发症及手术成功率等，术后随访12～18个月。结果全视网膜光凝和玻璃体腔注射avastin后1周内20眼虹膜新生血管均不同程度消退。术后最后一次随访发现，20眼中仅有3眼联合抗青光眼药物眼压≤21mmHg，其余17眼术后眼压控制在正常范围，手术成功率达到85％．最后一次随访，平均眼压（15．31±4．27）mmHg，与术前平均眼压（49．03±12．87）mmHg比较，差异有统计学意义（P＝0．000）。视力提高者8眼（40％），保持不变者10眼，下降2眼。术后并发症主要是早期的短暂性浅前房、高眼压及晚期的滤过道瘢痕纤维化。结论 Ahmed引流阀植入联合全视网膜光凝和玻璃体腔注射Avastin治疗新生血管性青光眼安全有效，有利于保护残留的视功能，手术成功率高，并发症少，可以作为新生血管性青光眼患者的首选手术方式之一。