CAJ | 학술논문

目的评价FP-7Ahmed青光眼引流阀治疗新生血管性青光眼的初步临床效果.方法回顾性病例系列研究.收集2009年1月至2010年6月住院行FP-7 Ahmed青光眼引流阀植入术治疗的36例(36只眼)新生血管性青光眼患者临床资料,进行回顾性分析.患者随访时间为术后1d、1周、1个月及之后的每3个月随访1次.随访内容主要包括患者术后眼压、最佳矫正视力、应用抗青光眼药物种类数及并发症等.手术成功标准为完全成功和条件成功.手术后不同时间点的眼压比较采用重复测量资料的方差分析,手术前后应用抗青光眼药物种类数比较采用秩和检验.结果患者术前眼压(39.5 ±9.7)mm Hg(1 mm Hg=0.133 kPa)；术后1d、1周、1个月、3个月及末次随访眼压分别为(19.2±8.9)、(11.8±3.8)、(13.7±4.8)、(16.9±5.3)及(16.9±6.8) mm Hg.不同时间点的眼压比较,采用重复测量的方差分析,差异有统计学意义(F=9.26,P＜0.05).术前应用抗青光眼药物1～6种,平均4种；术后应用抗青光眼药物0～3种,平均1种,术前后比较差异有统计学意义(Z =6.764,P＜0.05).FP-7Ahmed引流阀植入术完全成功率80.6％,条件成功率91.7％.术后并发症主要包括引流管阻塞、引流管暴露、浅前房及引流盘周围包裹性囊状泡,对症处理后眼压均可控制.结论 FP-7Ahmed青光眼引流阀植入术具有安全有效、并发症少等优点,可以作为新生血管性青光眼患者的首选治疗方式之一.
목적 평개FP-7Ahmed청광안인류벌치료신생혈관성청광안적초보림상효과.방법 회고성병례계렬연구.수집2009년1월지2010년6월주원행FP-7 Ahmed청광안인류벌식입술치료적36례(36지안)신생혈관성청광안환자림상자료,진행회고성분석.환자수방시간위술후1d、1주、1개월급지후적매3개월수방1차.수방내용주요포괄환자술후안압、최가교정시력、응용항청광안약물충류수급병발증등.수술성공표준위완전성공화조건성공.수술후불동시간점적안압비교채용중복측량자료적방차분석,수술전후응용항청광안약물충류수비교채용질화검험.결과 환자술전안압(39.5 ±9.7)mm Hg(1 mm Hg=0.133 kPa)；술후1d、1주、1개월、3개월급말차수방안압분별위(19.2±8.9)、(11.8±3.8)、(13.7±4.8)、(16.9±5.3)급(16.9±6.8) mm Hg.불동시간점적안압비교,채용중복측량적방차분석,차이유통계학의의(F=9.26,P＜0.05).술전응용항청광안약물1～6충,평균4충；술후응용항청광안약물0～3충,평균1충,술전후비교차이유통계학의의(Z =6.764,P＜0.05).FP-7Ahmed인류벌식입술완전성공솔80.6％,조건성공솔91.7％.술후병발증주요포괄인류관조새、인류관폭로、천전방급인류반주위포과성낭상포,대증처리후안압균가공제.결론 FP-7Ahmed청광안인류벌식입술구유안전유효、병발증소등우점,가이작위신생혈관성청광안환자적수선치료방식지일.
Objective To evaluate the efficacy and safety of FP-7 Ahmed glaucoma valves (AGV) implantation in neurovascular glaucoma (NVG) as the first choice of surgery.Methods This retrospective,comparative case series study collected a total of 36 eyes of 36 patients with neurovascular glaucoma who underwent AGV implantation in Zhongshan Ophthalmic Center from January 2009 to June 2010.Change of intraocular pressure (IOP),the best corrected visual acuity,numbers of anti-glaucoma medication,success rate and postoperative complications were followed up at day 1,week 1,month 1,and every 3 months after surgery.Complete success of surgery was rated as reduction of IOP≥30％ without medication and those who failed to meet criteria was rated as partial success.Data were analyzed by paired Student t-test for IOP,rank sum test for paired non-parametric numbers of medication,and repeated measures analysis of variance for comparison of IOP between different time points using SPSS 13.0.Results Compared with pre-operation,IOP was significant ( F =9.26,P ＜ 0.05 ) decreased after surgery with FP-7 AGV implantation ( 39.5 ±9.7) mm Hg(1 mm Hg=0.133 kPa)vs(9.2 ±8.9),(11.8 ±3.8),(13.7±4.8),(16.9±5.3),(16.9±6.8) mm Hg at day 1,week 1,month 1,month 3 and the last following-up of post-operation,respectively.The numbers of anti-glaucoma medication were significantly ( Z =6.764,P ＜ 0.05 ) reduced from4.0 (1-6) of pre-operation to 1.0 (1-3) of post-operation.At the last following up,the complete success rate after FP-7 AGV implantation was 80.6％,and qualified success rate was 91.7％.The postoperative complications including occlusion of the drainage tube,exposure of the drainage tube,shallow anterior chamber and encapsulated cystic blebs around the plate were controlled with additional treatment.Conclusions The clinical outcome indicated that the implantation of FP-7 AGV has a stable IOP lowering effect and fewer complications,which can be considered as one of the first choices for management of NVG.