Ahmed青光眼阀治疗难治性青光眼:印度患眼的经验

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Purpose: To evaluate the efficacy of the Ahmed Glaucoma Valve implant in refra ctory glaucomas in Indian eyes. Materials and methods: A retrospective review wa s conducted on the charts of 122 eyes of 122 patients with refractory glaucoma t reated with Ahmed Glaucoma Valve implant placement at Guru Nanak Eye Centre, New Delhi between January 1996 and December 1999. The main outcome measure was success at the last follow-up. Suc cess was defined as an intraocular pressure (IOP) of 22 mmHg or less and 5 mmHg or more and at least a 30%reduction in IOP without visually devastating complic ations or additional glaucoma surgery. Results: The mean postoperative IOP (17.2 9 ±.3.79 mmHg) was significantly (P < 0.001) lower than the mean preoperative I OP (31.47 ±7.86 mmHg) at last follow up (mean 12.51 ±.8.37 months; range 3-24 months). The cumulative probability of success by Kaplan Meier analysis was 85. 95%at 12 months and 82.83%at 24 months. The mean number of postoperative antig laucoma medications (0.75 ±.0.80) was also significantly lower (P< 0.001) than the mean preoperative number of antiglaucoma medications (2.83±0.72). The most common complication was corneal-tube contact, which occurred in five (4.10%) e yes. Retinal detachment occurred postoperatively in one eye with the clinical di agnosis of neovascular glaucoma secondary to Eale’s disease. Two patients had t ube extrusion requiring repositioning and reinforcement with scleral patch graft . Conclusions: Ahmed Glaucoma Valve implantation is an effective and relatively safe therapy for the treatment of refractory glaucoma in Indians. Purpose: To evaluate the efficacy of the Ahmed Glaucoma Valve implant in refra ctory glaucomas in Indian eyes. Materials and methods: A retrospective review of wa conducted on the charts of 122 eyes of 122 patients with refractory glaucoma t reated with Ahmed Glaucoma Valve implant placement at Guru Nanak Eye Center, New Delhi between January 1996 and December 1999. The main outcome measure was success at the last follow-up. Suc cess was defined as an intraocular pressure (IOP) of 22 mmHg or less and 5 mmHg or more and at least a 30% reduction in IOP for visually devastating complications or additional glaucoma surgery. Results: The mean postoperative IOP (17.2 9 ± .3.79 mmHg) was significantly (P <0.001) lower than the mean preoperative I OP (31.47 ± 7.86 The cumulative probability of success by Kaplan Meier analysis was 85. 95% at 12 months and 82.83% at 24 months. The mean number of postoperative follow-up (mean 12.51 ± .8.37 months; range 3-24 months) antig laucoma medications (0.75 ± 0.80) was also significantly lower (P <0.001) than the mean preoperative number of antiglaucoma medications (2.83 ± 0.72). The most common complication was corneal-tube contact, which occurred in five (4.10%) e yes Retinal detachment occurred post onely with one of the clinical di agnosis of neovascular glaucoma secondary to Eale’s disease. Two patients had t ube extrusion requiring repositioning and reinforcement with scleral patch graft. Conclusions: Ahmed Glaucoma Valve implantation is an effective and relatively safe therapy for the treatment of refractory glaucoma in Indians.
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