CAJ | 학술논문

背景临床研究已证实FP-7/FP-8 Ahmed青光眼引流阀治疗成人难治性青光眼有效且安全,但由于儿童青光眼的病理机制复杂及其临床表现的多样性,采用FP-7/FP-8 Ahmed青光眼引流阀治疗儿童难治性青光眼的疗效和安全性评价较少. 目的评价FP-7/FP-8 Ahmed青光眼引流阀治疗儿童难治性青光眼的临床效果.方法采用回顾性系列病例观察研究设计,纳入2008年10月至2011年4月于沧州市中心医院行FP-7/FP-8 Ahmed青光眼引流阀植入术的儿童青光眼患者26例30眼,患者年龄为4个月～16.5岁,包括先天性青光眼小梁/房角切开术后高眼压、晚期先天性青光眼、无晶状体眼或人工晶状体植入术后青光眼、外伤性青光眼和Sturge-Weber综合征.分别于术后1周及1、6、12、24个月复查,观察术眼术后眼压、手术并发症及手术成功率. 结果患者术前平均眼压为(36.93±10.56) mmHg(1 mmHg=0.133 kPa),术后1周及1、6、12、24个月眼压分别为(13.13±3.34)、(14.13±3.15)、(15.93±4.76)、(17.96±5.37)、(19.74±5.43) mmHg,不同时间点的眼压整体比较差异有统计学意义(F=58.929,P＜0.05);与术前眼压值比较,术后1周及1、6、12、24个月术眼眼压均明显下降,差异均有统计学意义(t=11.641、11.458、10.688、7.988、8.018,P＜0.05).本组术眼术后1周及1、6、12、24个月的累积总成功率分别为100％、96.67％、93.21％、85.76％和71.46％.术后共有8眼出现轻度并发症,包括浅前房4眼、引流管阻塞1眼、前房积血2眼和引流管暴露1眼,经药物或手术治疗后痊愈,未发现术后严重并发症.结论 FP-7/FP-8 Ahmed青光眼引流阀植入术治疗儿童难治性青光眼有效且安全,可作为儿童难治性青光眼的首选手术方式之一.
배경 림상연구이증실FP-7/FP-8 Ahmed청광안인류벌치료성인난치성청광안유효차안전,단유우인동청광안적병리궤제복잡급기림상표현적다양성,채용FP-7/FP-8 Ahmed청광안인류벌치료인동난치성청광안적료효화안전성평개교소. 목적 평개FP-7/FP-8 Ahmed청광안인류벌치료인동난치성청광안적림상효과.방법 채용회고성계렬병례관찰연구설계,납입2008년10월지2011년4월우창주시중심의원행FP-7/FP-8 Ahmed청광안인류벌식입술적인동청광안환자26례30안,환자년령위4개월～16.5세,포괄선천성청광안소량/방각절개술후고안압、만기선천성청광안、무정상체안혹인공정상체식입술후청광안、외상성청광안화Sturge-Weber종합정.분별우술후1주급1、6、12、24개월복사,관찰술안술후안압、수술병발증급수술성공솔. 결과 환자술전평균안압위(36.93±10.56) mmHg(1 mmHg=0.133 kPa),술후1주급1、6、12、24개월안압분별위(13.13±3.34)、(14.13±3.15)、(15.93±4.76)、(17.96±5.37)、(19.74±5.43) mmHg,불동시간점적안압정체비교차이유통계학의의(F=58.929,P＜0.05);여술전안압치비교,술후1주급1、6、12、24개월술안안압균명현하강,차이균유통계학의의(t=11.641、11.458、10.688、7.988、8.018,P＜0.05).본조술안술후1주급1、6、12、24개월적루적총성공솔분별위100％、96.67％、93.21％、85.76％화71.46％.술후공유8안출현경도병발증,포괄천전방4안、인류관조새1안、전방적혈2안화인류관폭로1안,경약물혹수술치료후전유,미발현술후엄중병발증.결론 FP-7/FP-8 Ahmed청광안인류벌식입술치료인동난치성청광안유효차안전,가작위인동난치성청광안적수선수술방식지일.
Background Clinical study showed that FP-7/FP-8 Ahmed glaucoma valve implantation is effective and safe for the adult refractory glaucoma.However,it is welt-known that childhood glaucomatous eyes have different pathogenesis and protean clinical manifestations.So the efficacy of FP-7/FP-8 Ahmed glaucoma valve implantation in child deserves some attention.Objective This study was to retrospectively evaluate the efficacy and safety of FP-7/FP-8 Ahmed glaucoma valve implantation for refractory glaucoma in children.Methods The clinical data of 30 eyes of 26 children with refractory glaucoma who undergone FP-7/FP-8 Ahmed glaucoma valve implantation in the Center Hospital of Cangzhou from October 2008 to April 2011 were retrospectively analyzed.The age of patients was 4 months to 16.5 years.The patients included ocular hypertension after trabculectomy/goniotomy for cogenital glaucoma,later stage of cogenital glaucoma,aphakic or pseudophakic glaucoma,traumatic glaucoma and Sturge-Weber syndrome.The follow-up ranged from 1 week to 24 months to obverse the changes of intraocular pressure (IOP),postoperative complications and cumulative success rate.Results The mean IOP was significantly different among various time points (F=58.929,P＜0.05).The IOP was (36.93± 10.56) mmHg in preoperation and (13.13± 3.34),(14.13±3.15),(15.93±4.76),(17.96±5.37),(19.74±5.43) mmHg 1 week,1 month,6 months,12 months,24 months following surgery,showing significant reduce after operation.Compared with preoperative IOP,the IOP of 1 week,1 month,6,12,24 months after AGI was significant decreased,with significant differences between them (t =11.641,11.458,10.688,7.988,8.018,all at P ＜ 0.05).The total cumulative success rate after Ahmed glaucoma valve implant was 100％,96.67％,93.21％,85.76％ and 71.46％ 1 week,1 month,6 months,12 months,24 months after surgery.The postoperative complications occurred in 8 eyes,including shallow anterior chamber,drainage tube obstruction,hyphema of anterior chamber and valve exposure,and these were cured by medicine and surgery.No serious complication appeared in all patients after operation.Conclusions FP-7/FP-8 Ahmed glaucoma valve implantation is an effective and safe method for the treatment of refractory glaucoma,and it can be considered as one of the first choices for management of refractory glaucoma in childhood.