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目的评价Ahmed青光眼阀门(AGV)植入物联合丝裂霉素C手术治疗难治性青光眼的临床效果,探讨其手术并发症以及处理。方法对52例难治性青光眼施行Ahmed青光眼阀门植入术,其中包括30例新生血管性青光眼,14例滤过手术失败的原发性青光眼,8例眼部手术后的继发性青光眼,术后随访3～12个月。结果在术后平均16±4个月的随访期间眼压由术前的41.40±8.03mmHg下降到20.55±9.53mmHg,总有效率为88.5%。手术并发症包括早期低眼压、前房延缓形成、脉络膜脱离和引流管堵塞、引流盘包裹等。结论Ahmed青光眼阀门近期疗效高于其他房水引流植入物,可使因引流过畅所致的并发症明显减少,而联合丝裂霉素C的应用可减少其远期并发症,为治疗难治性青光眼提供了一种新的有效的治疗途径。
Objective To evaluate the clinical efficacy of Ahmed glaucoma valve (AGV) implant combined with mitomycin C in the treatment of refractory glaucoma, and to investigate its complications and management. Methods 52 patients with refractory glaucoma underwent Ahmed glaucoma valve implantation, including 30 cases of neovascular glaucoma, 14 cases of primary glaucoma with failed filtration surgery and 8 cases of secondary glaucoma after ocular surgery Follow-up 3 to 12 months. Results Intraocular pressure decreased from 41.40 ± 8.03mmHg preoperatively to 20.55 ± 9.53mmHg during the follow-up period of 16 ± 4 months after operation. The total effective rate was 88.5%. Surgical complications include early hypotensive pressure, delayed anterior chamber formation, choroidal detachment and drainage tube blockage, drainage disk package and so on. Conclusions Ahmed glaucoma valve has higher curative effect than other aqueous drainage implants in the near future, which can significantly reduce the complication caused by excessive drainage, and the combination of mitomycin C can reduce its long-term complications. Governing glaucoma provides a new and effective therapeutic approach.