羊膜移植治疗Ahmed青光眼阀纤维包裹的临床应用研究

目的探讨Ahmed青光眼阀(AGV)引流盘包裹切除联合羊膜移植治疗难治性青光眼的有效性、安全性,并讨论其可能的机制。方法对20例24眼难治性青光眼再手术患者,切除Ahmed青光眼阀纤维包裹,并植入羊膜,观察术后眼压、滤过泡、前房、视力等情况,术后随访1～24个月,平均随访(8·2±4·5)个月,观察术后疗效。结果术后无浅前房等并发症,术后及随访期间眼压与术前比较均有降低,差异有统计学意义(P<0·005),滤过泡均为功能性滤过泡,视力保持不变或有所改善,手术完全成功率达84·8%。结论羊膜在Ahmed青光眼阀门植入术失败后再手术的应用明显提高了手术成功率,联合丝裂霉素C的应用可减少其远期并发症,使手术操作简便、易行、安全,值得在临床推广应用。

Amniotic Membrane Transplantation in the Management of Ahmed glaucoma valve fiber wrapped

Objective To examine the efficacy and safety of amniotic membrane transplantation combined with removal wrapped Ahmed glaucoma valve(AGV) in the treatment of refractory glaucoma.Methods Twenty eyes of 24 patients with refractory glaucoma surgery again, remove the fiber wrapped Ahmed glaucoma valve, Amnion and biological implant, postoperative IOP, filtering blebs, anterior chamber, vision and so on, Postoperative follow-up ranged from1~24 months.Results There were no complications such as shallow anterior chamber, and at follow-up period compared with preoperative lower intraocular pressure.the difference was statistically significant(P<0.005), filtering blebs were functional.vision remain unchanged or were improved, complete surgical success rate of 84.8%.Conclusion Amniotic membrane transplantation combined with resection the fiber wrapped Ahmed glaucoma valve is an effective and safe method for the treatment of refractory glaucoma.