CAJ | 학술논문

目的：：观察用23 G针头直接穿刺制作巩膜隧道的方式植入Ahmed青光眼阀( Ahmed glaucoma valve,AGV)治疗难治性青光眼的临床疗效及并发症。方法：观察44例44眼难治性青光眼患者,应用23 G针头直接穿刺制作巩膜隧道,行青光眼阀植入术进行治疗。观察患者术后眼压、视力、并发症,并与术前进行对比。结果：本组患者成功率84.1%。术前眼压：52.1±10.1mmHg,最后一次随访眼压15.6±6.9mmHg。视力提高者11眼,视力无改变者27眼,视力降低者6眼。并发症包括：浅前房4例,脉络膜脱离3例,引流管移位1例,前房积血6例,引流管阻塞1例,脉络膜驱逐性出血1例,引流盘包裹5例。结论：直接穿刺巩膜隧道的方法植入青光眼阀,手术操作简单可行,避免了制瓣及异体巩膜移植,并简化了手术操作,防止术后房水管周渗漏,术后浅前房发生率低,为切实可行的手术方法。
목적：：관찰용23 G침두직접천자제작공막수도적방식식입Ahmed청광안벌( Ahmed glaucoma valve,AGV)치료난치성청광안적림상료효급병발증。방법：관찰44례44안난치성청광안환자,응용23 G침두직접천자제작공막수도,행청광안벌식입술진행치료。관찰환자술후안압、시력、병발증,병여술전진행대비。결과：본조환자성공솔84.1%。술전안압：52.1±10.1mmHg,최후일차수방안압15.6±6.9mmHg。시력제고자11안,시력무개변자27안,시력강저자6안。병발증포괄：천전방4례,맥락막탈리3례,인류관이위1례,전방적혈6례,인류관조새1례,맥락막구축성출혈1례,인류반포과5례。결론：직접천자공막수도적방법식입청광안벌,수술조작간단가행,피면료제판급이체공막이식,병간화료수술조작,방지술후방수관주삼루,술후천전방발생솔저,위절실가행적수술방법。
To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.