Glaucoma Implant Tube Lumen Obstruction Visualized Using Anterior Segment Optical Coherence Tomography
Glaucoma Implant Tube Lumen Obstruction Visualized Using Anterior Segment Optical Coherence Tomography
复制标题
使用眼前段光学相干断层扫描可视化青光眼植入管管腔阻塞
DOI：
10.1097/ijg.0000000000000872
复制
发表时间：
2018
影响因子：
2
通讯作者：
Kiuchi Yoshiaki
中科院分区：
文献类型：
--
作者：
Nakakura Shunsuke;Noguchi Asuka;Noguchi Santaro;Hirose Yuka;Niimi Koji;Tabuchi Hitoshi;Kiuchi Yoshiaki
我们报告一例青光眼植入物管腔阻塞可视化与眼前节光学相干断层扫描（ASOCT），并提出其手术治疗。患者为一名66岁男性，患有难治性青光眼，在小梁切除术、几个滤过泡针刺手术和人工透镜巩膜固定联合睫状体平坦部玻璃体切除术后，右眼出现外伤性无晶状体眼。最后，我们在颞下象限的平坦部用几个舍伍德切口进行Baerveldt植入。然而，尽管最大剂量用药数周，他的眼内压（IOP）仍> 30 mm Hg。我们尝试了第二次玻璃体切除术，并完全清除了插管尖端周围的玻璃体;然而，术后几天他的IOP仍保持在40 mm Hg左右。因此，我们怀疑插管腔眼外点处的插管阻塞，并使用ASOCT进行评估。ASOCT显示管腔内有物质。我们拔出插管，然后压碎并从插管头端挤出阻塞材料。然后，我们将管重新固定在同一位置，术后眼压控制良好。我们的研究结果表明，ASOCT是有用的诊断青光眼植入管腔阻塞和手术决策。
We report a case of glaucoma implant tube lumen obstruction visualized with anterior segment optical coherence tomography (ASOCT) and present its surgical management. The patient was a 66-year-old man with refractory glaucoma associated with traumatic aphakia in the right eye after trabeculectomy, several bleb needling procedures, and scleral fixation of the intraocular lens with pars plana vitrectomy. Finally, we performed Baerveldt implantation at the pars plana of the temporal inferior quadrant with a several Sherwood slit. However, his intraocular pressure (IOP) was> 30 mm Hg despite maximum medication for several weeks. We attempted second vitrectomy and completely removed vitreous around the tube tip; however, his IOP remained around 40 mm Hg for several days after the surgery. Therefore, we suspected tube obstruction at the extraocular point of the tube lumen and used ASOCT for assessment. ASOCT revealed material in the tube lumen. We pulled out the tube and then crushed and extruded the obstructing material from the tube tip. We then refixed the tube at the same place and achieved good IOP control after the surgery. Our findings indicate that ASOCT is useful for diagnosing glaucoma implant tube lumen obstruction and surgical decision-making.