Preservation of corneal endothelium after pars plana tube insertion of the Ahmed glaucoma valve
Preservation of corneal endothelium after pars plana tube insertion of the Ahmed glaucoma valve
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DOI：
10.1007/s10384-011-0108-1
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发表时间：
2012-03-01
影响因子：
2.4
通讯作者：
Tanito, Masaki
中科院分区：
文献类型：
--
作者：
Chihara, Etsuo;Umemoto, Mitsuyoshi;Tanito, Masaki
目的探讨Ahmed青光眼阀（ppAGV）植入睫状体平坦部后的手术效果。在两个中心前瞻性研究了26例连续31只难治性青光眼患者接受ppAGV治疗后的角膜内皮损伤和术后并发症，角膜中央细胞密度（CD）分别下降3.5 +/- A 15.0和10.2 +/- A 18.9%。分别为6个月和12个月。1年时的CD损失与单纯白内障手术后的损失相当（6.5 +/- A 8.5%，P = 0.441）。抑制性（Hex）变化不大，从基线时的41.5 +/- A 15.6%变为6个月时的41.8 +/- A 14.9%（P = 0.976）和12个月时的41.6 +/- A 10.2%（P = 0.58）。中央角膜内皮面积（CV）的变异系数从基线时的40.7 +/- A 9.0%变为6个月时的45.7 +/- A 12.6%（P = 0.078）和12个月时的45.5 +/- A 11.2%（P = 0.013）。伴随白内障手术是CD丢失的重要风险因素。1年时成功或合格成功的概率分别为66.1%和83.6%。31只眼中有6只眼（19%）出现后节并发症，除2只眼（6%）因吻状脉络膜脱离而发生视网膜脱离外，其余均为自限性。
To investigate surgical outcomes after pars plana implantation of the Ahmed glaucoma valve (ppAGV).The intraocular pressure, corneal endothelial damage and post-surgical complications of 31 consecutive refractory glaucoma eyes of 26 subjects who underwent ppAGV were prospectively studied at two centers.Cell density (CD) at the central cornea decreased by 3.5 +/- A 15.0 and 10.2 +/- A 18.9% at 6 and 12 months, respectively. The CD loss at 1 year was comparable with the loss after cataract surgery alone (6.5 +/- A 8.5%, P = 0.441). Hexagonality (Hex) changed little, from 41.5 +/- A 15.6% at baseline to 41.8 +/- A 14.9% (P = 0.976) at 6 months and 41.6 +/- A 10.2% (P = 0.58) at 12 months. The coefficient of variation of the central corneal endothelium area (CV) changed from 40.7 +/- A 9.0% at baseline to 45.7 +/- A 12.6% (P = 0.078) at 6 months and 45.5 +/- A 11.2% (P = 0.013) at 12 months. Concomitant cataract surgery was a significant risk factor for CD loss. The probabilities of success or qualified success at 1 year were 66.1 and 83.6%, respectively. Most of the posterior segment complications, which were noted in 6 of 31 eyes (19%), were self-limiting, except for 2 eyes (6%) that developed retinal detachment as a consequence of kissing choroidal detachment.Corneal endothelial damage was minimal, and the success probability was relatively high after ppAGV in refractive glaucoma cases.