Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity
Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity
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DOI：
10.1155/2015/873124
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发表时间：
2015-01-01
影响因子：
1.9
通讯作者：
Zarnowski, Tomasz
中科院分区：
文献类型：
--
作者：
Rekas, Marek;Krix-Jachym, Karolina;Zarnowski, Tomasz
目的.在治疗恶性青光眼的拟议改良中确定部分后部玻璃体切除术（PPV）。方法.这项前瞻性、连续性、单中心病例系列研究涉及白内障和青光眼联合手术后或人工晶状体眼青光眼手术后发生恶性青光眼症状的患者。当药物和激光治疗不成功时，进行部分PPV，建立前房和玻璃体腔之间的沟通。疗效指标为眼内压（IOP）降低、矫正远视力（CDVA）和抗青光眼药物的数量。手术成功率和并发症的发生也进行了评价。结果该研究入组了17名患者的20只眼。术后1年，平均IOP从30.4 ± 14.2（SD）mmHg降至14.6 ± 3.2（SD）mmHg（P < 0.00001）。抗青光眼药物的数量从术前的3.3 ± 1.1（SD）减少到随访结束时的1.2 ± 1.1（SD），具有统计学显著性。术后3、6和12个月观察到CDVA的统计学显著改善。结论.前房和玻璃体腔之间建立连通的部分PPV可在12个月的观察期内有效控制IOP;然而，在大多数情况下，有必要使用抗青光眼药物控制IOP。
Purpose. Determination of partial posterior vitrectomy (PPV) in the proposed modification for treatment of malignant glaucoma. Methods. The prospective, consecutive, single-center case series study involved patients in whom symptoms of malignant glaucoma occurred after combined cataract and glaucoma surgery or after glaucoma surgery in pseudophakic eye. When medical and laser treatment were not successful, partial PPV with establishment of communication between the anterior chamber and the vitreous cavity was performed. Efficacy measures were intraocular pressure (IOP) reduction, corrected distance visual acuity (CDVA), AND the number of antiglaucoma medications. Surgical success and occurring complications were also evaluated. Results. The study enrolled 20 eyes of 17 patients. Average IOP was reduced from 30.4 +/- 14.2 (SD) mmHg to 14.6 +/- 3.2 (SD) mmHg one year after surgery (P < 0.00001). A statistically significant reduction of the number of antiglaucoma medications was obtained from 3.3 +/- 1.1 (SD) preoperatively to 1.2 +/- 1.1 (SD) at the end of follow-up. Statistically significant improvement of CDVA was observed 3, 6, and 12 months after surgery. Conclusions. Partial PPV with establishment of communication between the anterior chamber and the vitreous cavity enables effective IOP control over a 12-month observation; however, in most cases, it is necessary to use antiglaucoma medications for IOP control.