Effect of Glaucoma Tube Shunt Parameters on Cornea Endothelial Cells in Patients With Ahmed Valve Implants
Effect of Glaucoma Tube Shunt Parameters on Cornea Endothelial Cells in Patients With Ahmed Valve Implants
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DOI：
10.1097/ico.0000000000000301
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发表时间：
2015-01-01
期刊：
影响因子：
2.8
通讯作者：
Jeng, Bennie H.
中科院分区：
文献类型：
--
作者：
Koo, Euna B.;Hou, Jing;Jeng, Bennie H.
目的：本研究的目的是评估各种管参数对角膜内皮细胞密度（ECD）插入后的Ahmed valves.Methods：39眼的33例患者以前的颞上（ST）Ahmed阀植入和20眼的13名参与者以前简单的超声乳化和人工透镜植入术，但没有青光眼手术史进行了评价。用眼前节光学相干断层扫描仪测量各种管参数。测量ST、中央和鼻下（IN）ECD和角膜厚度。ST角膜的内皮细胞损失和角膜厚度与IN corneal.Results进行了比较：手术患者的平均年龄为58 +/- 22岁，青光眼手术后的平均时间为2.5 +/- 2.6年。39只研究眼中有32只为人工晶状体眼。青光眼导管手术眼ST段内皮的ECD显著低于IN内皮（P < 0.001），尽管ST段ECD的相对降低并不大于人工晶状体对照眼（P = 0.16）。在单变量分析中，当相对于IN ECD进行评估时，插管相对于角膜的角度和插管尖端到角膜的距离是ST段内皮细胞丢失减少的显著风险因素（分别为P = 0.01和P = 0.02）。在多变量分析中，只有管尖端到角膜的距离仍然与ST内皮细胞loss.Conclusions显着相关：虽然这是一项回顾性研究，具有固有的局限性，管更接近角膜似乎导致增加损失相邻的内皮细胞。
Purpose: The aim of this study was to assess the effect of various tube parameters on corneal endothelial cell density (ECD) after insertion of Ahmed valves.Methods: Thirty-nine eyes of 33 patients with previous super-otemporal (ST) Ahmed valve implantation and 20 eyes of 13 participants with previous uncomplicated phacoemulsification and intraocular lens implantation but no history of glaucoma surgery were evaluated. Various tube parameters were measured with anterior segment optical coherence tomography. ST, central, and inferonasal (IN) ECD and pachymetry were measured. Endothelial cell loss and corneal thickness in the ST cornea was compared with those in the IN cornea.Results: The mean age of the operated patients was 58 +/- 22 years, and the mean time since glaucoma surgery was 2.5 +/- 2.6 years. Thirty-two of the 39 study eyes were pseudophakic. The ECD was significantly lower in the ST endothelium than in the IN endothelium in eyes with glaucoma tube surgery (P < 0.001), although this relative reduction in ST ECD was not greater than that seen in pseudophakic control eyes (P = 0.16). In univariate analysis, tube angle relative to the cornea and distance from the tip of the tube to the cornea were significant risk factors for decreased ST endothelial cell loss when assessed relative to the IN ECD (P = 0.01 and P = 0.02, respectively). In multivariate analysis, only the distance of the tube tip to the cornea remained significantly associated with ST endothelial cell loss.Conclusions: Although this was a retrospective study with inherent limitations, tubes that are closer to the cornea seem to lead to increased loss of adjacent endothelial cells.