Ahmed青光眼阀治疗新生血管性青光眼术后浅前房的预防.doc

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1、Ahmed青光眼阀治疗新生血管性青光眼术后浅前房的预防作者：方爱武瞿佳孙传宾侯立杰【摘要】目的探讨Ahmed青光眼阀（AGV）置入术治疗新生血管性青光眼（NVG）术后浅前房的预防方法。方法对观察组31例（31眼）NVG行AGV前房置入术，术中预制旁刺口、前房注射粘弹剂及可吸收缝线结扎引流管，观察术后浅前房等并发症的发生率及手术效果，并与12例（12眼）按常规方法行AGV前房置入术者（对照组）进行比较。结果术后Ⅱ级以上浅前房的发生率：观察组为4/31，对照组为6/12，两组差异有统计学意义（P＜0.05）；观察组平均随访时间(12.29±11.18)个月，最后随访眼压平均为(23.45±12

2、.04)mmHg，不用降眼压药，6mmHg≤最后随访眼压≤21mmHg17例，完全成功率为54.84%，予局部应用降眼压药，眼压≤21mmHg6例，相对成功率为19.35%，总成功率为74.19%；对照组：平均随访时间(11.08±8.08)个月，最后随访眼压平均为(27.81±12.04)mmHg，不用降眼压药，最后随访眼压≤21mmHg6例，占50.00%，予局部应用降眼压药，眼压≤21mmHg2例，相对成功率为12.67%，总成功率为66.67%。结论Ahmed青光眼阀前房置入术术中预制旁刺口、应用透明质酸钠及可吸收缝线结扎引流管等综合措施可预防NVG术后浅前房的发生及由浅前房引起的

3、一系列并发症。【关键词】青光眼Ahmed青光眼阀　　【Abstract】ObjectiveToinvestigateeffectivewaysforprecautionofshallowofanteriorchamberafterimplantationofahmedglaucomavalve(AGV)totreatneovascularglaucoma.MethodsIntreatinggroup,31eyesof31patientswithNVGweretreatedwithAGVimplantplacementinanteriorchamberwithintraoperativepa

4、racentesis,partialligationofasiliconetubeofAGVandinjectionvisco-elasticmaterialwereperformedon31eyesof31patients.AndaconventionalAGVimplantplacementwereperformedin12eyesof12patientsascontrolgroup.Themainoutcomemeasurewastherateofearlypostoperativeshallowanteriorchamberandthepostoperativeintraocula

5、rpressure(IOP).Andtheoutcomewascomparedbetweenthetwogroups.Successwasdefinedasanintraocularpressureof21mmHgorless.ResultsEarlypostoperativegrade2shallowanteriorchamberoccurredin4patients(4eyes)intheligationgroupandin6patients(6eyes)incontrolgroup(t=4.75，P<0.05).Fortheligationgroup,Thefollow-upp

6、eriodswereover3months.Theintraocularpressurewasreducedto23.45+/-13.27mmHgatthemostrecentfollow-upaftersurgerywithameanfollow-upof12.29+/-11.18months(range,3to48months).therewere17eyes(54.84%)thatwereclassifiedascomplete5successes,6eyes(19.35%)thatwerequalifiedsuccesses,Forthecontrolgroup,atlastfol

7、low-up（morethan3months）intraocularpressurewasreducedto27.81+/-12.04mmHg，therewere6eyes(50.00%)classifiedascompletesuccesses,2eye(16.67%)thatwerequalifiedsuccessesnormal.ConclusionsThetechniqueincludingintraoperat