穿透性角膜移植聯合房水引流裝置植入治瘵嚴重角膜病變合并青光眼

目的觀察穿透性角膜移植聯合房水引流裝置植入術治瘵嚴重角膜病變合并難治性青光眼的臨床效果和安全性.方法1996年以來對13衹嚴重角膜病燮合并難治性青光眼的患眼一次施行穿透性角膜移植術和Ahmed青光眼閥植入術.術後随診觀察至少11個月,平均20個月.觀察項目主要是角膜移植片的透明情况、房水引流裝置的硅管有無阻塞、視力、眼壓和并發癥.結果視力提高者10衹眼(76.9%),眼壓降至正常者11衹眼(84.6%),角膜植片透明者9衹眼(69.2%),房水引流管通暢者12衹眼(92.3%).結論穿透性角膜移植術同時聯合房水引流裝置植入術治瘵嚴重角膜病燮合并青光眼可達到滿意的降眼壓效果,改善角膜移植片的透明度,提高患者的視功能.

Penetrating keratoplasty and Ahmed Glaucoma Valve implantation in refractoryglaucoma and serious corneal opacity

Objective To investigate the effect and safety of penetrating keratoplasty combined with human aqueous humor drainage implant. Methods Penetrating keratoplasty and Ahmed Glaucoma Valve implantation were performed on 13 eyes with serious corneal opacity and refractory glaucoma. They were followed up for at least 11 months, with an average of 20 months. The items to be observed in the follow-up period were eorneal graft's transparency, occluison of the aqueous drainage tube, visual acuity, intraocular pressure and complications. Results Visual acuity in 10 eyes (76.9%)was increased. The intraocular pressure in 11 eyes(84.6%) was controlled within normal range. Corneal graft in 9 eyes (69.2%) was transparent. The tube was occluded by vitreous only in one eye (7.7%). Conclusion The results show that penetrating keratoplasty combined with Ahmed Glaucoma Valve implantation can control the intraocular pressure and improve the prognosis of eorneal graft and visual acuity in cases with serious eorneal opacity and refractory glaucoma.