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要約 目的:血管新生緑内障(NVG)に対するバルベルト緑内障インプラント(BGI)とアーメド緑内障バルブ(AGV)手術の術後成績の比較検討。
対象と方法:NVGに対していずれかのチューブシャント手術を施行され,6か月以上経過観察した36例37眼を対象とし,術前後の眼圧,有害事象について検討した。
結果:36例37眼(BGI 20例21眼,AGV 16例16眼)。平均年齢は64.5±13.7歳,BGIの術前,術後6か月の平均眼圧は38.1±9.9mmHg,15.7±5.5mmHg,AGVの術前,術後6か月の平均眼圧は41.6±8.9mmHg,14.7±5.3mmHgと両群ともに有意に低下した(p<0.05)。有害事象はBGIでチューブ閉塞(2眼),前房出血(1眼),硝子体出血(1眼),脈絡膜剝離(3眼),AGVでチューブ閉塞(1眼),前房出血(1眼),網膜剝離(1眼)であった。
結論:NVGに対するチューブシャント手術はいずれの術式においても良好に眼圧を下降させる。合併症の発症頻度に関しては有意差がなかった。
Abstract Purpose:To report and compare the outcome of Baerveldt glaucoma implant(BGI)and Ahmed glaucoma valve(AGV)for neovascular glaucoma.
Cases and Method:This retrospective study was made on 37 eyes of 36 patients with neovascular glaucoma. BGI was implanted in 21 eyes and AGV was implanted in 16 eyes. Cases were followed up for 6 months or longer. The age of 36 patients averaged 65 years.
Results:Intraocular pressure(IOP)in 21 eyes implanted with BGI averaged 38.1±9.9 mmHg before surgery and 15.7±5.5 mmHg 6 months after surgery. IOP in 16 eyes implanted with AGV averaged 41.6±8.9 mmHg before surgery and 14.7±5.3 mmHg 6 months after surgery. In both groups, IOP decreased significantly after surgery. There was no significant difference between the two groups regarding decrease of IOP. Adverse effects after implantation of BGI comprised tube occlusion in 2 eyes, hyphema in one eye, vitreous hemorrhage in one eye, and choroidal detachment in 3 eyes. Adverse effect after implantation of AGV comprised tube occlusion, hyphema and retinal detachment in one eye each.
Conclusion:IOP decreased 6 months after implantation of BGI or AGV in eyes with neovascular glaucoma. There was no significant difference in the incidence of complications between BGI and AGV.
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