Ahmed青光眼阀治疗新生血管性青光眼术后浅前房预防.docVIP

Ahmed青光眼阀治疗新生血管性青光眼术后浅前房预防 　 作者：方爱武 瞿佳 孙传宾 侯立杰 【摘要】 目的 探讨Ahmed青光眼阀（AGV）置入术治疗新生血管性青光眼（NVG）术后浅前房的预防方法。 方法 对观察组31例（31眼）NVG行AGV前房置入术，术中预制旁刺口、前房注射粘弹剂及可吸收缝线结扎引流管，观察术后浅前房等并发症的发生率及手术效果，并与12例（12眼）按常规方法行AGV前房置入术者（对照组）进行比较。 结果 术后Ⅱ级以上浅前房的发生率：观察组为4/31，对照组为6/12，两组差异有统计学意义（P＜0.05）；观察组平均随访时间(12.29±11.18)个月，最后随访眼压平均为(23.45±12.04)mmHg，不用降眼压药，6mmHg≤最后随访眼压≤21mmHg 17例，完全成功率为54.84%，予局部应用降眼压药，眼压≤21mmHg 6例，相对成功率为19.35%，总成功率为74.19%；对照组：平均随访时间(11.08±8.08)个月，最后随访眼压平均为(27.81±12.04)mmHg，不用降眼压药，最后随访眼压≤21mmHg 6例，占50.00%，予局部应用降眼压药，眼压≤21mmHg 2例，相对成功率为12.67%，总成功率为66.67%。 结论 Ahmed青光眼阀前房置入术术中预制旁刺口、应用透明质酸钠及可吸收缝线结扎引流管等综合措施可预防NVG术后浅前房的发生及由浅前房引起的一系列并发症。 【关键词】 青光眼 Ahmed青光眼阀 　　【Abstract】 Objective To investigate effective ways for precaution of shallow of anterior chamber after implantation of ahmed glaucoma valve(AGV) to treat neovascular glaucoma . Methods In treating group ,31 eyes of 31 patients with NVG were treated with AGV implant placement in anterior chamber with intraoperative paracentesis, partial ligation of a silicone tube of AGV and injection visco-elastic material were performed on 31 eyes of 31 patients. And a conventional AGV implant placement were performed in 12 eyes of 12 patients as control group . The main outcome measure was the rate of early postoperative shallow anterior chamber and the postoperative intraocular pressure (IOP). And the outcome was compared between the two groups. Success was defined as an intraocular pressure of 21 mm Hg or less. Results Early postoperative grade 2 shallow anterior chamber occurred in 4 patients (4eyes)in the ligation group and in 6 patients (6 eyes) in control group(t=4.75，Plt;0.05). For the ligation group, The follow-up periods were over 3 months. The intraocular pressure was reduced to 23.45 +/- 13.27 mm Hg at the most recent follow-up after surgery with a mean follow-up of 12.29 +/- 11.18 months (range,3 to 48 months). there were 17eyes (54.84%) that were classified as complete successes, 6 eyes (19.35%) that were qualified successes, For the