阀门植入治疗难治性儿童青光眼的研究（附4例病例报告）

发布时间：2018-05-25 17:40

本文选题：难治性青光眼 + 儿童　；参考：《浙江大学》2010年硕士论文

【摘要】： 目的评价难治性儿童青光眼Ahmed阀门植入术后的近期疗效以及相关手术并发症及处理。材料与方法随访2008年3月至2010年3月期间于浙江大学医学院附属第二医院眼科中心住院病人中行Ahmed阀门植入术治疗的难治性儿童青光眼患儿4例,年龄6-10岁,随访时间7-24月,观察术后眼压控制、视力、手术并发症、用青光眼药物等情况,评价术后的近期和远期疗效,手术相关并发症及防治等。通过文献检索,综述有关阀门植入术治疗儿童青光眼的相关研究和进展。结果2008年3月至2010年3月期间本院住院儿童青光眼患者中行Ahmed阀门植入术治疗的共4例(4只眼),其中1例Sturge-Weber综合征继发青光眼、1例Coat's病继发青光眼和2例滤过手术失败的先天性青光眼。4名患儿行青光眼阀门植入手术。4例术后眼压均较术前明显下降,使用的降眼压药物明显减少；均无术中并发症发生；术后视力稳定同术前；仅1眼(Coat's病)术后16月时因视网膜脱离导致低眼压和浅前房,出现引流管口与角膜内皮层接触,颞上方角膜内皮失代偿,无其他术中及术后并发症发生。结论青光眼阀门植入术对于这4例难治性儿童青光眼的术后近期眼压控制较好,无术中并发症发生。阀门植入术可考虑作为难治性儿童青光眼的首选术式。关于青光眼阀门对儿童患者治疗的有效性,尤其是长期有效性还需更多的临床研究。
[Abstract]:Objective to evaluate the short-term effect of Ahmed valve implantation for refractory glaucoma in children. Materials and methods from March 2008 to March 2010, 4 children (aged 6-10 years) with refractory glaucoma treated by Ahmed valve implantation were followed up for 7-24 months. Intraocular pressure control, visual acuity, postoperative complications and glaucoma drugs were observed to evaluate the short-term and long-term results, surgical complications, prevention and treatment. This paper reviews the research and progress of valve implantation in the treatment of glaucoma in children. Results from March 2008 to March 2010, 4 cases of glaucoma were treated with Ahmed valve implantation, including 1 case of Sturge-Weber syndrome secondary glaucoma, 1 case of Coat's disease secondary glaucoma and 2 cases of filtering hands. The intraocular pressure of 4 children with congenital glaucoma who failed surgery was significantly lower than that before operation, and the intraocular pressure of 4 patients who underwent glaucoma valve implantation was significantly lower than that before operation. No intraoperative complications occurred; postoperative visual acuity was stable with preoperative; only 1 eye had Coatsdisease) 16 months after operation, low intraocular pressure and shallow anterior chamber were caused by retinal detachment, and there was contact between drainage orifice and corneal endothelium. The superior temporal corneal endothelium was decompensated and no other intraoperative and postoperative complications occurred. Conclusion the intraocular pressure of the 4 cases of refractory glaucoma was well controlled after glaucoma valve implantation, and no intraoperative complications occurred. Valve implantation can be considered as the first choice for refractory glaucoma in children. More clinical research is needed on the effectiveness of glaucoma valves in the treatment of children, especially in the long-term.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

【共引文献】