Retinal complications after aqueous shunt surgical procedures for glaucoma
Retinal complications after aqueous shunt surgical procedures for glaucoma
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DOI：
10.1001/archopht.1996.01100140671004
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发表时间：
1996-12-01
影响因子：
--
通讯作者：
Mieler, WF
中科院分区：
文献类型：
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作者：
Law, SK;Kalenak, JW;Mieler, WF
目的：为了评估视网膜并发症，并确定视网膜并发症的危险因素后，水分流processors.Materials和方法：38个连续的水分流程序，进行了36例患者在眼科研究所的医学院威斯康星州，密尔沃基，从1993年6月至1995年3月（最低随访，6个月）的记录进行了审查。平均+/-SD随访时间为11.4+/-5.2个月结果：12例患者（32%）有以下视网膜并发症：4例浆液性脉络膜积液（10%）需要引流，3例脉络膜上腔积液（8%），2例玻璃体积液（5%），1例孔源性视网膜脱离（3%），1例眼内炎（3%），巩膜外压1例（3%）。这12例患者中有8例（67%）需要进行视网膜并发症手术。12例患者中有9例（75%）视力下降2行或以上。术后视网膜并发症的中位发病时间为12.5天，其中10名患者（83%）在35天内出现并发症。另外10名患者（26%）出现浆液性脉络膜积液，这些积液自行消退。另外10例患者中有2例（20%）视力下降2行或更多。发生严重视网膜并发症的患者年龄明显较大，高血压和术后眼压过低的发生率较高。严重的视网膜并发症在Krupin阀和椎间盘以及莫尔特诺和Baerveldt器械的患者中均匀分布。Ahmed青光眼阀植入物的经验是limited.Conclusion：水分流程序可能与显着的视网膜并发症和随后的视力丧失。
Objectives: To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures.Materials and Methods: Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean+/-SD follow-up was 11.4+/-5.2 months (median, 10.5 months).Results: Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited.Conclusion: Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.