青光眼引流阀植入术与小梁切除术对巩膜扣带术后难治性青光眼疗效

目的 评价Ahmed青光眼引流阀植入术与小梁切除术在巩膜扣带术后难治性青光眼治疗中的疗效比较.方法 接受滤过手术的巩膜扣带术后难治性青光眼41例(41眼).其中Ahmed青光眼引流阀植入术19例(阀门组),小梁切除术22例(小梁组).分析两组术后1年内的成功率、眼压降幅、视力、并发症和合并用药情况.结果 12个月阀门组的成功率为63.16％；小梁组为31.82％.阀门组成功率显著高于小梁组(X2=4.027,P=0.0427).阀门组术后12个月眼压均值为(16.5 ±4.9)mm Hg；小梁组术后12个月为(19.8 ±4.3)mm Hg.阀门组眼压显著低于小梁组(t=2.1102,P=0.0427).两组术后视力变化、并发症及合并青光眼药物使用情况均无差异.结论 Ahmed青光眼引流阀植入术较之小梁切除术,具有更为持久的降眼压作用和相似的安全性,是治疗巩膜扣带术后难治性青光眼的有效方法 .

Outcomes of Ahmed glaucoma valve implantation versus trabeculectomy in the treatment of refractory glaucoma after scleral buckling

Objective To evaluate the efficacy and safety of Ahmed glaucoma valve implantation versus trabeeuleetomy in the treatment of refractory glaucoma after scleral buckling. Methods A total of 41 eyes of 41 patients with glaucoma after scleral buckling who accepted Ahmed glaucoma valve implantation or trabeeuleetomy were enrolled, including 19 patients in the valve group and 22 patients in the trabeculectomy group. The successful rate, intraocular pressure （IOP） reduction, visual acuity, complications and medical therapy were observed for one year. Results The successful rate was 63.16% in the valve group 12 months after surgery, and 31.82% in the trabeculeetomy group. The success rate in the valve group was significantly higher than that in the trabeculectomy group at 12 months follow-up （X2 = 4. 027, P = 0.0427） . IOP decreased from （24.7 ±2.8） mmHg at baseline to （ 16.5 ±4.9） mmHg in the valve group 12 months after surgery, and it decreased from （25.5 ± 3.6 ） mmHg to （19.8 ± 4.3 ） mmHg in the trabeculeetomy group. The lOP in the valve group was significantly lower than that in the trabeculectomy group at 12 months follow- up （ t = 2. 1102, P = 0.0427 ）. There was no significant difference in visual acuity, complications or medical therapy between those two groups. Conclusion Compared with trabeeulectomy, Ahmed glaucoma valve implantation is an option with more persistence and same security in the treatment of glaucoma after scleral buckling.