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題名 | The Experience of Ahmed Glaucoma Valve Implantation in Patients with Intractable Glaucoma=使用亞曼氏青光眼濾過瓣治療頑強性青光眼之經驗 |
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作者 | 陳柏良; 呂大文; 周秉義; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 40:2 2001.06[民90.06] |
頁次 | 頁125-131 |
分類號 | 416.748 |
關鍵詞 | 亞曼氏青光眼濾過瓣; 頑強性青光眼; Ahmed glaucoma valve implant; Intractable glaucoma; Hypotony; Success rate; |
語文 | 英文(English) |
中文摘要 | 目的:本篇報告對於使用內科治療、雷射治療及傳統手術,無法達到良好控制眼 壓的頑強性青光眼患者,使用亞曼氏青光眼濾過瓣以獲得較佳眼壓控制的臨床經驗。方法: 20 位病人 20 隻眼睛使用亞曼氏青光眼濾過瓣以治療頑強性青光眼, 病人平均追蹤期間為 12.2 ± 0.8 個月,病人平均年齡為 54.2 ± 1.8 歲。 手術成功定義為在不另外進行青光 眼手術下,眼壓值小於 22 毫米汞柱且大於 5 毫米汞柱。 而手術後便用降眼壓藥物並不列 為手術成功或失敗條件。所有病人在手術前後皆測量最佳矯正視力、眼壓值以做為評估比較 ,另外並以詳細之眼科理學檢查包括裂隙燈檢查、眼底鏡等,以期早期發現後之併發症。結 果: 術後最後一次追蹤眼壓平均為 16.4 ± 5.8 mmHg, 比手術前平均眼壓 41.1 ± 11.1 mmHg 呈統計學有意義下降 (P<0.001)。在青光眼藥物使用方面,術後平均使用 0.3 ± 0.2 種藥物,也比術前 2.7 ± 1.2 種藥物明顯減少許多 (P<0.01),視力有進步或相同在 1 行 Snellen 內的有 19 隻眼睛 (95 % )。 有十三隻眼睛產生術後之併發症,但大多數並不影 響手術的成果,而手術成功率依我們之前的定義可達百分之九十五。結論:亞曼氏青光眼濾 過瓣對頑強性青光眼的患者提供良好降眼壓效果,而一般不含瓣片青光眼濾過植入物後所常 易發生之眼壓過低之現象,在使用亞曼氏青光眼濾過瓣患者也較少發生。因此亞曼氏青光眼 濾過瓣對於控制頑強性青光眼的患者之眼壓不失為一良好手術方式。 |
英文摘要 | Purpose:To report the clinical experience of intraocular pressure (IOP) lowering effect of Ahmed Glaucoma Valve implant on patients with intractable glaucoma. Methods: Twenty eyes (20 patients) with intractable glaucoma treated with the Ahmed Glaucoma Valve implants were enrolled in this study. The mean follow-up time was 12.2 ± 0.8 months. The mean age was 54.2 ± 1.8 years. Surgical success was defined as IOP less than 22 mmHg and greater than 5 mmHg without additional glaucoma surgery. Postoperative use of antiglaucoma medications was not a criterion for success or failure. All patients received detail ophthalmic examination including slit lamp, IOP, and visual acuity with best correction in preoperative and postoperative periods. The difference in variables before and after Ahmed Glaucoma Valve implant surgery was compared by paired t-test. Results:The mean IOP was reduced from 41.1 ± 11.1 mmHg before surgery to 16.4 ± 5.8 mmHg at the last follow-up after surgery (P<0.001). The number of antiglaucoma medications was decreased from preoperative 2.7 ± 1.2 to 0.3 ± 0.2 after surgery (P<0.01)., The visual acutity was improved or within one Snellen line in 19 eyes (95%). Although complications occurred in 13 eyes, the majority of which did not affect surgical outcome. The success rate by our definition was 95%. Conclusion:The Ahmed Glaucoma Valve implant is effective in lowering IOP in patients with intractable glaucoma. Postoperative hypotony, as frequently encountered in other non-valve drainage implants, is not common with this implant. From our study, it revealed that the Ahmed Glaucoma Valve implant provides an alternative ways to control IOP in patients with intractable glaucoma in intermediate term follow-up. |
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