Retrospective Review of Pars Plana Versus Anterior Chamber Placement of Baerveldt Glaucoma Drainage Device
Retrospective Review of Pars Plana Versus Anterior Chamber Placement of Baerveldt Glaucoma Drainage Device
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DOI：
10.1097/ijg.0b013e31829d9be2
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发表时间：
2015-02-01
影响因子：
2
通讯作者：
Grigg, John
中科院分区：
文献类型：
--
作者：
Rososinski, Anthony;Wechsler, David;Grigg, John
目的：评价Baerveldt青光眼引流装置(GDD)平坦部(PP)和前房(AC)植入的效果。方法：本研究是一项非随机、回顾性的病例系列研究，在5个中心的2名外科医生的监督下，对63只使用Baerveldt 350青光眼引流器植入GDD的患者进行评估。引流管要么插入AC，要么通过PP插入玻璃体切除的玻璃体腔内。手术在2003至2010年间进行，患者最少随访6个月。记录两组患者术后眼压、视力、降压用药次数、手术并发症等资料。结果：63例引流装置手术中，34例置管于AC，29例置入PP后段。AC组和PP组的术前平均眼压分别为32.3±20.3 mm Hg和32.8±18.4 mm Hg。两组患者术后平均眼压在所有随访时间点均有下降。术后1、2、3年平均眼压前置管组分别为14.0、12.9、14.0 mm Hg，PP组分别为14.2、14.2、14.0 mm Hg。两年后，PP组和AC组的合格成功率分别为94%和91%，而PP组和AC组的绝对成功率分别为35%和27%。结论：在无晶状体眼、人工晶状体眼和玻璃体切除眼中，在需要避免放置前管(如并存的角膜病变)的情况下，将Baerveldt GDD管插入PP是一种安全有效的眼压控制方法。眼压控制效果似乎与传统的AC放置相当。
Purpose: To evaluate outcomes of pars plana (PP) versus anterior chamber (AC) placement of Baerveldt glaucoma drainage device (GDD).Methods: This study is a nonrandomized, retrospective case series evaluating 63 eyes that underwent GDD insertion with Baerveldt 350 device under the supervision of 2 surgeons at 5 centers. The drainage tube was either inserted into the AC or through the PP into the vitreous cavity where eyes had been vitrectomized. Surgery was conducted between 2003 and 2010 with minimum patient follow-up of 6 months. Data on postoperative intraocular pressure (IOP), visual acuity, number of hypotensive medications, and surgical complications were recorded.Results: Of the 63 drainage device surgeries, 34 tubes were placed in the AC and 29 were placed into the posterior segment through the PP. Preoperative mean IOP was 32.3 +/- 20.3 mm Hg in the AC group and 32.8 +/- 18.4 mm Hg in the PP group. Postoperative mean IOP was reduced at all follow-up time points in both the groups. Postoperative mean IOP in the anterior tube group was 14.0, 12.9, and 14.0 mm Hg and in the PP group was 14.2, 14.2, and 14.0 mm Hg, at the 1-, 2-, and 3-year follow-up, respectively. The qualified success rate at 2 years was 94% for the PP group and 91% for the AC group, whereas absolute success was 35% for the PP group and 27% for the AC group at 2-year follow-up.Conclusions: Insertion of the tube of the Baerveldt GDD into the PP is a safe and effective method for IOP control in aphakic, pseudophakic, and vitrectomized eyes where there is a need to avoid anterior tube placement such as coexisting corneal pathology. IOP control results appear comparable to conventional AC placement.