关键词: Ahmed引流阀, 硅油充填, 难治性青光眼, 安全性, 有效性

Abstract: Objective To evaluate the safety and efficacy of Ahmed glaucoma valve in the treatment of refractory glaucoma in eyes with silicone oil tamponade under different lens statuses. Design Retrospective case series. Participants 62 patients (62 eyes) with refractory glaucoma after vitrectomy with silicone oil tamponade who were admitted to the glaucoma department of the Eye Hospital affiliated to Shandong University of Traditional Chinese Medicine from June 2015 to December 2021. Methods The medical records of the patients before and after operation 3 months later were reviewed. Included patients (eyes) were divided into three groups: phakic group (26 patients 26 eyes), IOL group (16 patients, 16 eyes) and aphakic group (20 patients, 20 eyes). The successful operation is defined as the introcular pressure (IOP) being 6~21 mmHg with or without the anti-glaucoma drugs after the operation, without serious complications and other anti-glaucoma operations. Main Outcome Measures The success rate, IOP, the number of anti-glaucoma drugs and the incidence of silicone oil entering drainage tube, the incidence of other complications. Results The total post-operative success rate was 85.5% for all patients 3 months later. The success rate of phakic eyes, IOL eyes and aphakic eyes was 96.2%, 87.5%, 70.0% respectively, with significant difference among the three groups (P=0.041). The success rate of phakic eyes was higher than aphakic eyes (P=0.033), with no significant difference among the other groups. The IOP of phakic eyes（16.93±1.75）mmHg and pseudophakic eyes (18.45±2.78) mmHg were lower than aphakic eyes (22.56±3.10 ) mmHg after 3-month follow-up, with statistically significant difference among the three groups（all P<0.01）. The number of anti-glaucoma drugs used before the operation was 4 (4, 5) and was 0 (0, 1.25) after operation for all patients, the difference was statistically significant （Z=6.96, P=0.000). There was no significant difference in the number of anti-glaucoma drugs used before and after operation among the three groups. The proportion of silicone oil entering the drainage tube in aphakic, pseudophakic and aphakic groups was 1/26, 2/16 and 6/20 respectively (P=0.041). The incidence of shallow anterior chamber in each group was 2/26, 2/16 and 0/20 respectively（P=0.282）, The incidence of anterior chamber hemorrhage in each group was 2/26, 2/16 and 2/20 respectively （P=0.871）. No other serious complications occurred. Conclusion The success rate is relatively higher in phakic and pseudophakic eyes than aphakic eyes. The risk of silicone oil entering the drainage tube in aphakic eyes is higher. (Ophthalmol CHN, 2022, 31: 340-345)

Key words: Ahmed glaucoma valve；silicone oil injection；refractory glaucoma, safety, efficacy