Follow-up of the original cohort with the Ahmed glaucoma valve implant
Follow-up of the original cohort with the Ahmed glaucoma valve implant
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DOI：
10.1016/s0002-9394(99)00080-x
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发表时间：
1999-08-01
影响因子：
4.2
通讯作者：
Wilson, MR
中科院分区：
文献类型：
--
作者：
Topouzis, F;Coleman, AL;Wilson, MR
目的：研究 Ahmed 青光眼阀植入物对已报告短期结果的复杂性青光眼患者的长期结果。 方法：在这项多中心研究中，我们分析了 60 名植入 Ahmed 青光眼阀的患者的 60 只眼睛的队列的长期结果。失败的特征是至少有以下一种情况：最后两次就诊时眼压均大于 21 毫米汞柱，最后两次就诊时眼压均低于 6 毫米汞柱、光感丧失、额外的青光眼手术、破坏性并发症以及移除或更换艾哈迈德青光眼阀植入物。严重的并发症包括慢性眼压过低、视网膜脱离、恶性青光眼、眼内炎和眼球痨；我们还报告了将角膜并发症（角膜失代偿或水肿、角膜移植失败）定义为破坏性并发症的结果。 结果：60 只眼睛的平均随访时间为 30.5 个月（范围为 2.1 至 63.5 个月）。当角膜并发症纳入失败的定义时，26只眼（43%）被视为失败。第 1 年、第 2 年、第 3 年和第 4 年的累积成功概率分别为 76%、68%、54% 和 45%。当角膜并发症被排除在失败的定义之外时，13只眼睛（21.5%）被视为失败。第 1 年、第 2 年、第 3 年和第 4 年的累积成功概率分别为 87%、82%、76% 和 76%。术后12个月随访后大部分失败是因为角膜并发症。结论：Ahmed青光眼阀植入物的长期性能与其他引流装置相当。艾哈迈德青光眼瓣膜植入物植入后 12 个多月，最常见的不良后果是角膜失代偿或角膜移植失败。这些角膜问题可能是继发于具有引流装置的眼睛类型或引流装置本身的问题。需要进一步调查以确定引流装置植入后角膜问题的原因。 (C) 1999 年，Elsevier Science Inc. 保留所有权利。
PURPOSE: To study the long-term results of the Ahmed glaucoma valve implant in patients with complicated glaucoma in whom short-term results have been reported.METHODS: In this multicenter study, we analyzed the long-term outcome of a cohort of 60 eyes from 60 patients in whom the Ahmed glaucoma valve was implanted. Failure was characterized by at least one of the following: intraocular pressure greater than 21 mm Hg at both of the last two visits less than 6 mm ng at both of the last two visits, loss of light perception, additional glaucoma surgery, devastating complications, and removal or replacement of the Ahmed glaucoma valve implant. Devastating complications included chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis, and phthisis bulbi; we also report results that add corneal complications (corneal decompensation or edema, corneal graft failure) as defining a devastating complication.RESULTS: The mean follow-up time for the 60 eyes was 30.5 months (range, 2.1 to 63.5). When corneal complications were included in the definition of failure, 26 eyes (43%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 76%, 68%, 54%, and 45%, respectively. When corneal complications were excluded from the definition of failure, 13 eyes (21.5%) were considered failures. Cumulative probabilities of success at 1, 2, 3, and 4 years were 87%, 82% 76%, and 76%, respectively. Most of the failures after 12 months of postoperative follow up were because of corneal complications.CONCLUSIONS: The long-term performance of the Ahmed glaucoma valve implant is comparable to other drainage devices. More than 12 months after the implantation of the Ahmed glaucoma valve implant, the most frequent adverse outcome was corneal decompensation or corneal graft failure. These corneal problems may be secondary to the type of eyes that have drainage devices or to the drainage device itself. Further investigation is needed to identify the reasons that corneal problems follow drainage device implantation. (C) 1999 by Elsevier Science Inc. All rights reserved.