中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
10期
778-781
,共4页
王宇冉%苗青%孙利娜%杨白冰
王宇冉%苗青%孫利娜%楊白冰
왕우염%묘청%손리나%양백빙
青光眼,难治性%青光眼引流阀,Ahmed%丝裂霉素C( MMC)
青光眼,難治性%青光眼引流閥,Ahmed%絲裂黴素C( MMC)
청광안,난치성%청광안인류벌,Ahmed%사렬매소C( MMC)
Glaucoma,refractory%Glaucoma valve,Ahmed%Mitomycin C
目的：评价Ahmed青光眼引流阀联合丝裂霉素C( MMC)治疗难治性青光眼的临床效果。方法2011年6月至2013年5月Ahmed青光眼引流阀植入联合MMC治疗的难治性青光眼26例(27眼)，术后随访12个月，观察视力、眼压、角膜内皮细胞计数、抗青光眼药物使用情况及并发症。结果27眼中手术完全成功20眼，条件成功3眼，失败4眼，手术成功率为85.19%。末次随访视力与术前差异无统计学意义。术前1周，术后1周、术后1、3、6及12个月，眼压分别为(45.65±13.78)、(7.42±5.44)、(24.67±10.34)、(17.26±3.70)、(15.18±3.52)及(16.03±3.82)mmHg(1 mmHg=0.133 kPa)，术后眼压较术前明显降低，术后各时间点的眼压与术前比较差异均有统计学意义。术前术后角膜内皮细胞密度比较，差异无统计学意义。末次随访抗青光眼药物应用平均(0.49±1.17)种与术前的(4.12±0.23)种相比较，差异有统计学意义。术后并发症主要包括早期浅前房、低眼压、前房积血、脉络膜脱离及中远期的引流盘包裹。结论使用Ahmed青光眼引流阀植入联合MMC手术操作简单，对眼部组织损伤小，是治疗难治性青光眼有效且安全的方法。
目的：評價Ahmed青光眼引流閥聯閤絲裂黴素C( MMC)治療難治性青光眼的臨床效果。方法2011年6月至2013年5月Ahmed青光眼引流閥植入聯閤MMC治療的難治性青光眼26例(27眼)，術後隨訪12箇月，觀察視力、眼壓、角膜內皮細胞計數、抗青光眼藥物使用情況及併髮癥。結果27眼中手術完全成功20眼，條件成功3眼，失敗4眼，手術成功率為85.19%。末次隨訪視力與術前差異無統計學意義。術前1週，術後1週、術後1、3、6及12箇月，眼壓分彆為(45.65±13.78)、(7.42±5.44)、(24.67±10.34)、(17.26±3.70)、(15.18±3.52)及(16.03±3.82)mmHg(1 mmHg=0.133 kPa)，術後眼壓較術前明顯降低，術後各時間點的眼壓與術前比較差異均有統計學意義。術前術後角膜內皮細胞密度比較，差異無統計學意義。末次隨訪抗青光眼藥物應用平均(0.49±1.17)種與術前的(4.12±0.23)種相比較，差異有統計學意義。術後併髮癥主要包括早期淺前房、低眼壓、前房積血、脈絡膜脫離及中遠期的引流盤包裹。結論使用Ahmed青光眼引流閥植入聯閤MMC手術操作簡單，對眼部組織損傷小，是治療難治性青光眼有效且安全的方法。
목적：평개Ahmed청광안인류벌연합사렬매소C( MMC)치료난치성청광안적림상효과。방법2011년6월지2013년5월Ahmed청광안인류벌식입연합MMC치료적난치성청광안26례(27안)，술후수방12개월，관찰시력、안압、각막내피세포계수、항청광안약물사용정황급병발증。결과27안중수술완전성공20안，조건성공3안，실패4안，수술성공솔위85.19%。말차수방시력여술전차이무통계학의의。술전1주，술후1주、술후1、3、6급12개월，안압분별위(45.65±13.78)、(7.42±5.44)、(24.67±10.34)、(17.26±3.70)、(15.18±3.52)급(16.03±3.82)mmHg(1 mmHg=0.133 kPa)，술후안압교술전명현강저，술후각시간점적안압여술전비교차이균유통계학의의。술전술후각막내피세포밀도비교，차이무통계학의의。말차수방항청광안약물응용평균(0.49±1.17)충여술전적(4.12±0.23)충상비교，차이유통계학의의。술후병발증주요포괄조기천전방、저안압、전방적혈、맥락막탈리급중원기적인류반포과。결론사용Ahmed청광안인류벌식입연합MMC수술조작간단，대안부조직손상소，시치료난치성청광안유효차안전적방법。
Objective To evaluate the clinical effect of Ahmed glaucoma valve ( AGV) combined with the application of Mitomycin C ( MMC) for the treatment of refractory glaucoma. Methods Data of 27 eyes of 26 patients with refractory glaucoma from June 2011 to May 2013 who underwent AGV implantation were collected. The follow-up time was 12 months. The visual acuity, intraocular pressure ( IOP) , corneal endothelial counting, anti-glaucoma medication used and complications were observed. Results The surgeries were completely successful in 20 eyes , conditionally successful in 3 eyes, failed in 4 eyes. And the success rate was 85. 19%. The difference in visual acuity was not statistically significant between preoperation and the last follow-up. The IOP 1 week before operation, and 1 week, 1, 3, 6 and 12 month after operation were (45. 65 ± 13. 78),(7. 42 ± 5. 44),(24. 67 ± 10. 34),(17. 26 ± 3. 70),(15. 18 ± 3. 52) and (16. 03 ± 3. 82) mmHg (1 mmHg = 0. 133 kPa) respectively. The postoperative IOP decreased significantly compared with preoperative one, and the difference in IOP between preoperation and any timepoint after operation was statistically significant. The difference in corneal endothelial counts between preoperation and postoperation was not statistically significant. The kinds of anti-glaucoma medicine used before operation and at the last follow-up after operation were ( 0. 49 ± 1. 17 ) and ( 4. 12 ± 0. 23 ) respectively, and the difference was statistically significant. The main postoperative complications included shallow anterior chamber, low IOP, hyphema, choroidal detachment and the parcel of drainage plate. Conclusion AGV implantation combined with the application of MMC is easy, effective and safe for the treatment of refractory glaucoma.
