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目的评价运用异体巩膜瓣覆盖的Ahmed阀植入术治疗难治性青光眼的临床疗效。方法收集2004年1月至2005年11月施行异体巩膜瓣覆盖的Ahmed青光眼阀植入术治疗的难治性青光眼29例(30眼),对手术前后的眼压、抗青光眼药物种类、视力等进行比较,对术后并发症进行统计分析。结果术前、术后2周、术后6周、术后3个月后眼压分别为(47．92±11．86)mmHg、(9．54±3．94)mmHg、(22．53±10．64)mmHg、(22．77±11．55)mmHg,术后眼压较术前明显降低,但随着随访时间的延长,眼压有上升的趋势；术后与术前比较矫正视力变化不明显。术后并发症主要有浅前房(16．7%)、高眼压(20%)、引流管暴露(13．3%)。结论用异体巩膜瓣覆盖的Ahmed阀植入术是治疗难治性青光眼有效方法,术中使用粘弹剂、结扎引流管可减少术后浅前房的发生。
Objective To evaluate the clinical effect of Ahmed valve implantation covered by allogeneic scleral flap in the treatment of refractory glaucoma. Methods Twenty-nine patients (30 eyes) with intractable glaucoma valve implantation underwent allogeneic scleral flap implantation from January 2004 to November 2005 were enrolled in this study. Intraocular pressure (IOP), anti-glaucoma medication, visual acuity Compare, analyze the postoperative complications. Results The intraocular pressure (IOP) before operation, 2 weeks after operation, 6 weeks after operation and 3 months after operation were (47.92 ± 11.86) mmHg, (9.54 ± 3.94) mmHg, (22.53 ± 10.64) mmHg and (22.77 ± 11.55) mmHg respectively. The intraocular pressure (IOP) after operation was significantly lower than that before operation, but the IOP increased with the extension of follow-up time Visual acuity is not obvious. Postoperative complications included shallow anterior chamber (16.7%), ocular hypertension (20%), and drainage tube exposure (13.3%). Conclusions Ahmed valve implantation covered by allogeneic scleral flap is an effective method for the treatment of refractory glaucoma. Viscoelastic technique and ligation of drainage tube can reduce the incidence of postoperative shallow anterior chamber.