目的:报告在一系列中国患者中使用Ahmed青光眼阀(AGV)植入术治疗葡萄膜炎后继发性青光眼的长期结局。
方法:回顾性研究包括56例接受AGV植入术的葡萄膜青光眼患者的67只眼。治疗的成功定义为患者在有或没有其他抗青光眼药物的情况下达到6至21mmHg的眼内压(IOP)水平和/或从基线IOP降低至少20%。主要结果测量包括IOP,手术后1、3、6、12、24、36、48和60mo的青光眼药物数量,手术并发症,最终最佳矫正视力(BCVA),视野(VF)和视网膜神经纤维层(RNFL)。
结果:平均随访时间为53.3±8.5(范围48至60)个月。累计成功率为98.5%,95.5%,89.6%,83.6%,76.1%,70.1%,在1、3、6、12、24、36、48和60个月时,分别为65.7%和61.2%,分别。眼压从基线30.8±6.8降至9.9±4.1、10.1±4.2、10.9±3.7、12.9±4.6、13.8±3.9、13.2±4.6、12.3±3.5和13.1±3.7mmHg,分别在1、3、6、12、24、36、48和60mo,分别为(P<0.01)。在研究期间的所有时间点,术后青光眼药物的数量与基线相比均显着减少(P<0.05)。术前、术后BCVA差异无统计学意义。术后未发现明显的手术并发症。术后患者VF和RNFL均稳定。
结论:AGV植入在降低眼压方面是安全有效的,减少青光眼药物的数量,维持葡萄膜性青光眼患者的视力。
OBJECTIVE: To report long-term outcomes of secondary glaucoma due to uveitis treated with Ahmed glaucoma valve (AGV) implantation in a series of Chinese patients.
METHODS: The retrospective study included 67 eyes from 56 patients with uveitic glaucoma who underwent AGV implantation. Success of the treatment was defined as patients achieving intraocular pressure (IOP) levels between 6 and 21 mm Hg with or without additional anti-glaucoma medications and/or a minimum of 20% reduction from baseline IOP. The main outcome measurements included IOP, the number of glaucoma medications at 1, 3, 6, 12, 24, 36, 48 and 60mo after surgery, surgical complications, final best-corrected vision acuity (BCVA), visual field (VF) and retinal nerve fiber layer (RNFL).
RESULTS: The mean follow-up was 53.3±8.5 (range 48 to 60)mo. The cumulative probability of success rate was 98.5%, 95.5%, 89.6%, 83.6%, 76.1%, 70.1%, 65.7% and 61.2% at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively. IOP was reduced from a baseline of 30.8±6.8 to 9.9±4.1, 10.1±4.2, 10.9±3.7, 12.9±4.6, 13.8±3.9, 13.2±4.6, 12.3±3.5 and 13.1±3.7 mm Hg at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively (P<0.01). The number of postoperative glaucoma medications was significantly decreased compared with baseline at all time points during the study period (P<0.05). There was no significant difference between preoperative and postoperative BCVA. Remarkable surgical complications were not found after surgery. The VF and RNFL of the patients were stable after the surgery.
CONCLUSIONS: AGV implantation is safe and effect in terms of reducing IOP, decreasing the number of glaucoma medications, and preserving vision for patients with uveitic glaucoma.