Ahmed阀植入对角膜内皮细胞的影响

目的 观察Ahmed阀植入术对角膜内皮细胞的影响。方法 回顾性病例研究。对21例（21眼）难治性青光眼行Ahmed阀植入术。术眼于术前1 d和术后1周、1个月、3个月、6个月、12个月，对侧眼于术前1 d和术后12个月行角膜内皮镜检查，记录角膜内皮细胞密度，计算角膜内皮细胞丢失率；测量眼压、前房深度，观察引流管位置。角膜内皮细胞密度值比较采用方差分析。结果 行Ahmed阀植入术的21眼术后角膜内皮细胞密度均下降，随着时间的推移，角膜内皮细胞丢失逐步增多，术后1周、1个月、3个月、6个月和12个月内皮细胞密度分别为（2299±234）个/mm2、（2062±234）个/mm2、（2015±223）个/mm2、（1999±222）个/mm2和（1901±210）个/mm2，与术前的（2306±229）个/mm2比较，差异有统计学意义（F=15.3，P<0.01）。术后各时间点角膜内皮细胞丢失率分别为0.3%、10.5%、12.6%、13.2%、17.5%。结论 Ahmed阀植入术后，角膜内皮细胞短期内存在丢失现象。

The influence of Ahmed glaucoma valve implantation on the corneal endothelium

Objective To evaluate the influence of Ahmed glaucoma valve implantation on the corneal endothelium during a one-year follow-up period. Methods In a retrospective case study， 21 patients （21 eyes） with refractory glaucoma underwent Ahmed glaucoma valve implantation. The corneal endothelium was assessed by spectral microscopy 1 day preoperatively and 1 week and 1， 3， 6 and 12 months postoperatively. Density and loss ratio of the corneal endothelium cells were assessed and calculated. Intraocular pressure （IOP）， anterior chamber depth （AC） and the position of the drainage tube were also observed. An analysis of variance （ANOVA） was used to compare corneal endothelial cell density at the different time points. Results The density of corneal endothelium cells decreased after Ahmed glaucoma valve implantation in all 21 eyes. The loss ratio of the corneal endothelium increased over time. Compared to a preoperative value of 2306±229 cells/mm2， the corneal endothelium at 1 week postoperatively was 2299±234 cells/mm2， at 1 month was 2062±234 cells/mm2， at 3 months was 2015±223 cells/mm2， at 6 months was 1999±222 cells/mm2， and at 12 months was 1901±210 cells/mm2 （F=15.3， P<0.01）. The loss ratio of the corneal endothelium were 0.3%， 10.5%， 12.6%， 13.2%， 17.5%. Conclusion There is a loss in corneal endothelium during the short time period after Ahmed glaucoma valve implantation.