青光眼             1075                                      PO0448

　　Ahmed Glaucoma Valve implantation in Refractory Glaucoma: 4-Year Results

　　赵平1, James C. Tsai2

　　沈阳市爱尔眼科医院  110003

　　Objective: To evaluate the longer-term outcome of Ahmed Glaucoma Valve (AGV) implanted in refractory glaucoma.

　　Methods: Retrospective review of consecutive patients underwent AGV implantation by one surgeon (JCT) with the follow-up period at least 3 months. Patients with age less than 18 at the date of surgery and additional glaucoma surgery at the same time of AGV implant were excluded from the study. The longer term clinical course (survival curve analysis up to 48 months) was reviewed. Surgical success was defined as IOP greater than 6 mmHg and less than 21 mmHg without additional glaucoma surgery or devastating complications. IOP and number of medications used at the post-op visits at day 1, 1 week, 1 month, 3 months, 6 months and every 6 months thereafter (up to 48 months) were recorded.

　　Results: 77 patients and 77 eyes are included in the study, including 19 primary open angle glaucoma, 18 chronic angle closure glaucoma, 17 inflammatory glaucoma, 15 neovascular, 3 primary angle closure, 2 traumatic, 1 pseudoexfolic, 1 steroid associated and 1 congenital glaucoma. The mean IOP decreased from 32.9 mmHg before surgery to 10.5 mmHg at 48 months of follow-up, and the number of medications decreased from 3.6 to 2.0 respectively. The 4-year success rate remained to 81.2%. Eight cases of failure were noted; with the median time of failure was 6.5 months. Major complications after surgery included choroidal effusion, iris occlusion of implant tube, wound dehiscence, hyphema, vitreous hemorrhage and retinal detachment.

　　Conclusions: Ahmed Glaucoma Valve implantation is a successful surgery for up to 4 years of follow-up in the treatment of refractory glaucoma.

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