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目的:探讨引流植入物手术治疗难治性青光眼的有效性和安全性。方法:采用Ahmed青光眼阀引流植入物(AhmedGlaucomaValve,AGV)治疗难治性青光眼41例44只眼,其中20只深前房眼选择AGV植入术,24只浅前房眼或前房有玻璃体者选择AGV植入联合晶体和或前玻璃体切除术,所有病例术中均应用丝裂霉素C(MitomycinC,MMC),术后平均随访15个月。结果:术后末次随访时眼压为148±843mmHg,比术前降低702%,P<0001;术后眼压在8～20mmHg之间者41只眼,手术成功率为932%;术后视力提高二行以上者21只眼(477%)。AGV联合手术与单纯AGV植入术比较,前者一次手术成功率875%,前房延缓形成42%,引流管堵塞42%;而后者分别为50%、40%及30%。结论:AGV植入联合前玻璃体切除术和或晶体摘除,可提高一次手术成功率,减少术后并发症;手术同期可行人工晶体缝合固定,并能处理其他伴随病变,不仅减少多次手术给患者造成的痛苦,而且在控制眼压的同时挽救了一定的视力。
Objective: To investigate the efficacy and safety of drainage implants in the treatment of refractory glaucoma. Methods: Ahmed glaucoma valve implantation (Ahmed GlaucomaValve, AGV) 41 patients with refractory glaucoma in 44 eyes, including 20 deep anterior chamber eyes selected AGV implantation, 24 shallow anterior chamber or anterior chamber vitreous Who underwent AGV implantation and / or anterior vitrectomy. Mitomycin C (MMC) was applied in all cases and the average follow-up was 15 months. Results: The intraocular pressure at the final follow-up was 148 ± 843mmHg, 702% less than before surgery (P <0001). The intraoperative IOP was 41% in 8-20mmHg. The operative success rate was 932%. The postoperative visual acuity 21 eyes (477%) were improved more than two lines. AGV combined surgery and simple AGV implantation, the former successful operation rate of 875%, anterior chamber delayed formation of 42%, drainage tube blockage of 42%; and the latter were 50%, 40% and 30%. Conclusion: AGV combined with anterior vitrectomy and / or crystal removal can improve the success rate of one operation and reduce the postoperative complications. It is feasible to suture and fix the intraocular lens with AGV and to treat other accompanying lesions, not only to reduce the number of surgeries to patients Caused by the pain, but also in the control of intraocular pressure saved a certain degree of vision.