关键词: 新生血管性青光眼, 青光眼引流阀, 巩膜隧道

Abstract:

Objective To evaluate the efficacy of Ahmed glaucoma valve (AGV) implantation via two different pathways on intraocular pressure (IOP) and complications in patients with neovascular glaucoma (NVG). Design Retrospective comparative case series. Participants Twenty cases (20 eyes) with NVG were undergone AGV implantations in First Hospital of Fujian Medical University. Methods Ten cases (10 eyes) were treated with scleral flaps implantation (SF group), the other 10 cases (10 eyes) were treated with scleral tunnels implantation (ST group). In the scleral tunnel group, a 27G needle was inserted into the anterior chamber parallel to the iris at 4 mm from temporal-superior corner limbus to form a tunnel for inserting a drainage tube of Ahmed glaucoma valve. A follow-up ranged from 1 to 29 months (mean 11.6±5.77 months). Main Outcome Measures IOP, surgical success rate and complications with slit-lamp. Results Compared with pre-operation, IOP was significantly reduced to 17.0±8.97 mmHg in the SF group, while significantly decreased to 18.5±7.78 mmHg in the ST group at the end of follow-up. The difference of IOP at each time point in each group was statistically significant compared with that before surgery. However, there was no significant difference in IOP between two groups at each time point of follow-up. The complete success rate of SF group was 60% and the partial success rate of 30%. The complete success rate of ST group was 80% and the partial success rate of 20%. The complete success rate between two groups was statistically significant (P=0.035), while the partial success rate was not statistically significant (P=0.487). The incidence of shallow anterior chamber with low tension of the ST group (0 case) was significantly lower than that of the SF group (4 cases) (P=0.0433). Conclusion The efficacy is similar between the two different pathways of AGV implantations in patients with NVG. Our results indicate that the procedure via scleral tunnels is simpler and convenient with a lower incidence of shallow anterior chamber with low tension within one year. (Ophthalmol CHN, 2019, 28: 34-38)

Key words: neovascular glaucoma, glaucoma valve, scleral tunnel