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首页> 外文期刊>Journal of glaucoma >Combined baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma.
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Combined baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma.

机译：Baerveldt青光眼引流植入物和小梁切除术联合丝裂霉素C联合治疗难治性青光眼。

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PURPOSE To describe the surgical technique and clinical outcomes of a procedure for refractory glaucoma, concurrent Baerveldt glaucoma implant (BGI) and trabeculectomy with mitomycin C.MATERIALS AND METHODS Medical records of all patients who underwent combined Prolene-ligated BGI and trabeculectomy with mitomycin C were retrospectively reviewed. Main outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual acuity, and complications. Kaplan-Meier survival analysis was used to determine success, defined as IOP < 22 mm Hg, no reoperation for glaucoma, and no loss of light perception vision.RESULTS The mean +/- SD follow-up period for 38 eyes of 36 patients was 34 +/- 36 months (range, 3-121 months), during which 18 of 38 eyes (47%) required laser suture lysis of the Prolene suture. Intraocular pressure was reduced from a mean (+/- SD) preoperative value of 35.7 +/- 12.8 to 12.7 +/- 4.7 mm Hg at 1-year follow-up and 11.9 +/- 5.5 mm Hg at the last follow-up visit ( < 0.001). Number of medicines used for glaucoma was reduced from a mean +/- SD preoperative value of 2.5 +/- 0.9 to 0.5 +/- 0.6 at 1-year follow-up and 0.6 +/- 0.8 at the last follow-up visit ( < 0.001). LogMar visual acuity remained stable at mean of 1.15 +/- 0.85 preoperatively, compared with 1.14 +/- 1.05 at 1-year follow-up, but declined to 1.61 +/- 1.01 at the last follow-up visit, a loss of an average of four lines of vision ( = 0.004). Cumulative success was 91% at year 1, 86% at year 2, and 81% at year 3. Three eyes (8%) had suprachoroidal hemorrhages, one eye (3%) needed reoperation for an extruded implant, one (3%) eye had poor vision due to chronic hypotony, three eyes (8%) required additional glaucoma surgery during the postoperative period, and one eye (3%) needed revision of the implant for pressure control.CONCLUSIONS Combined BGI and mitomycin C trabeculectomy provides excellent postoperative IOP control in patients with refractory glaucoma.
机译：目的描述难治性青光眼，并发Baerveldt青光眼植入物（BGI）和小梁切除术联合丝裂霉素C的手术技术和临床结果。回顾性审查。主要预后指标为眼压（IOP），青光眼用药数量，视力和并发症。用Kaplan-Meier生存分析确定成功率，定义为IOP <22 mm Hg，无青光眼再手术，无视力丧失。结果36例患者的38眼平均+/- SD随访时间为34 +/- 36个月（范围3-121个月），其间38眼中有18眼（47％）需要对Prolene缝合线进行激光缝合。眼内压从术前的平均（+/- SD）值从35.7 +/- 12.8降低到12.7随访时的12.7 +/- 4.7 mm Hg，最后一次随访时的11.9 +/- 5.5 mm Hg访问（<0.001）。用于青光眼的药物数量从术前1年随访的平均+/- SD术前值从2.5 +/- 0.9降低到0.5 +/- 0.6，在最近一次随访中为0.6 +/- 0.8（ <0.001）。术前LogMar视力保持稳定，平均为1.15 +/- 0.85，而一年随访时为1.14 +/- 1.05，但在最后一次随访时下降至1.61 +/- 1.01，失去了视力。四个视线的平均值（= 0.004）。第一年累积成功率为91％，第二年累积为86％，第三年累积为81％。三只眼（8％）发生脉络膜上腔出血，一只眼（3％）需再次手术以种植体，另一只（3％）眼由于慢性肌张力低下而导致视力不佳，三只眼（8％）在术后需要额外的青光眼手术，另一只眼（3％）需要对植入物进行翻修以控制压力。难治性青光眼患者的眼压控制。

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