目的:探讨Ahmed青光眼阀植入术后盘周包裹囊状泡再次手术的疗效。方法:回顾系列病例研究,收集2004-01/2008-12施行Ahmed青光眼阀植入术后盘周包裹囊状泡致再次眼压升高7例7眼患者的临床资料,进行回顾性分析。患者眼压升高时间为阀门术后1～6(平均2)mo。行再次手术术前检查:眼压升高不能药物控制,阀门管位置正常,管口畅,无堵塞物,于赤道部引流盘所在位置可见局限隆起包裹的囊状泡。所有患者均在局部麻醉下行包裹囊状泡切除术,术中均使用丝裂霉素,观察术后眼压及病程转归情况。结果:术后1mo,所有患者的眼压均在正常范围内,手术成功率100%;术后6mo,2例患者的眼压在无药物应用的情况,眼压控制在15.00mmHg左右,3例患者在应用2～3种降眼压眼液的情况下,眼压控制在21mmHg以下,手术成功率71%(5/7)。2例患者药物无法控制眼压,需进一步采取手术治疗。结论:对于Ahmed青光眼阀植入术后盘周包裹囊状泡的治疗,行包裹囊状泡切除术是一种可行的治疗方法。

AIM:To evaluate the efficacy of reoperation for encapsulated cystic blebs after Ahmed glaucoma valve implantation. ·METHODS:The series cases of 7 eyes 7 patients with elevated intraocular pressure (IOP) induced by proliferation around Ahmed value were retrospectively studied. The IOP increased at 1 month to half a year,2 months in average. Secondary surgery preoperative examination:the elevation could not be controled by medicine,the plate and valve tube position was normal,the orifice was smooth without stemming,localized encapsulated cystic blebs were found in the equator of eyeball in which the plate was located. All patients underwent encapsulated cysts resection combined with mitomycin-C under conjunctival flaps. The changes of IOP and the outcome of the diseases were observed. ·RESULTS:At 1 month after surgery,all patient’s IOP were in the normal range,and the surgery success ratio was 100%;at 6 months after the surgery,2 patient’s IOP kept the normal level (15.00mmHg) without any anti-glaucoma medications.The normal IOP level were in 3 cases by using 2 or 3 different kinds of anti-glaucoma medications,and surgery success rate was 71% (5/7). IOP beyond control were in 2 cases,and further surgical treatment was necessary.·CONCLUSION:It is considered an effective method of surgical treatment for encapsulated cystic blebs around Ahmed value.

R779.6