Glaucoma associated with keratoprosthesis
Glaucoma associated with keratoprosthesis
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DOI：
10.1016/s0161-6420(98)94034-9
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发表时间：
1998-04-01
期刊：
影响因子：
13.7
通讯作者：
Dohlman, CH
中科院分区：
文献类型：
--
作者：
Netland, PA;Terada, H;Dohlman, CH
目的：本研究旨在回顾作者在严重角膜疾病患者人工角膜相关性青光眼中的临床经验。设计：研究设计是对病例系列的回顾性分析。参与者：作者研究了52例人工角膜患者的55只眼，随访时间为21 ± 16个月（范围，3-77个月）。干预：青光眼引流装置植入36眼（35枚Ahmed瓣膜，1枚Krupin瓣膜），随访21 ± 15个月（范围，3-64个月）。主要结果测量：临床结果评估包括视力、眼内压（IOP）、视野、视盘外观和并发症的识别。在大多数（64%）接受人工角膜治疗的眼睛中发现了青光眼，术前有20只眼睛（36%），术后有15只眼睛（28%）。在接受青光眼引流装置治疗的36只眼中，29只眼（81%）的IOP得到控制，9只眼（25%）需要额外药物治疗。在36只植入人工角膜和青光眼引流植入物的眼睛中，5只（14%）发生青光眼持续进展（其中4只眼睛在手术前有晚期青光眼视神经损伤）。有9例因引流植入物引起的非视力威胁并发症。与术前相比，术后视力明显提高者占63%，视力不变者占17%，视力下降者占20%。结论：人工角膜术后眼压升高是常见的，青光眼引流植入物是有效的预防或治疗方法。
Objective: This study aimed to review the authors clinical experience with glaucoma associated with keratoprosthesis in patients with severe corneal disease.Design: The study design was a retrospective review of case series.Participants: The authors studied 55 eyes in 52 patients with keratoprostheses with follow-up of 21 +/- 16 months (range, 3-77 months).Intervention: Glaucoma drainage devices were implanted in 36 eyes (35 Ahmed valves, 1 Krupin valve) with 21 +/- 15 months' follow-up (range, 3-64 months).Main Outcome Measures: Clinical outcome assessment included vision, intraocular pressure (IOP), visual fields, optic disc appearance, and identification of complications.Results: Glaucoma was found in the majority (64%) of eyes treated with keratoprostheses, identified in 20 eyes (36%) before surgery and an additional 15 eyes (28%) after surgery. Of the 36 eyes treated with glaucoma drainage devices, IOP was controlled in 29 eyes (81%), with 9 eyes (25%) requiring additional medications. Continued progression of glaucoma occurred in 5 (14%) of 36 eyes with keratoprostheses and glaucoma drainage implants (4 of these eyes had advanced glaucomatous optic nerve damage before surgery). There were nine nonvision-threatening complications due to drainage implants. Compared with the preoperative visual acuity, vision was markedly improved in 63%, unchanged in 17%, and worse in 20% of eyes after keratoprosthesis surgery.Conclusion: Elevation of IOP is common in patients with keratoprosthesis, and prevention or treatment with glaucoma drainage implants is effective.