对Ahmed添加肌霉素C瓣膜植入物对难治性青光眼患者一年随访的有效性的评价

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia Pub Date : 2025-07-28 DOI:10.1016/j.oftal.2025.06.003

O. Teherán , C. Parra , E. Ramos , M. Ochoa , W. Escobar

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引用次数: 0

摘要

Ahmed瓣膜适用于最大药物治疗难治性青光眼和适当的滤过手术。瓣膜周围纤维化组织的形成会影响手术的成功；已经采用了各种策略来预防这种情况，包括使用抗代谢物，如丝裂霉素C （MMC）。目的评价丝裂霉素C （MMC）在难治性青光眼患者艾哈迈德瓣膜植入术中的有效性和安全性。方法将34例患者分为2组，每组17例：1组（使用MMC）和2组（未使用MMC），随访1年。在没有使用抗青光眼药物的情况下，眼内压（IOP）在6-18 mmHg之间是完全成功的定义；合格的成功是指相同的IOP范围，但与抗青光眼药物相关，而失败的特征是IOP超出该范围，严重的并发症或再干预。结果1组总成功率为88.2%，2组总成功率为94.2%。组1平均眼压降低18.0±11.5 mmHg，组2平均眼压降低11.3±5.0 mmHg （p = 0.0352）。第一组患者高血压期发生率为17.6%，第二组为70.6% （p = 0.0048）。结论MMC的使用减少了Ahmed瓣膜置换术中观察到的高血压期，从而达到更好的IOP控制。

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Evaluación de la efectividad del implante de válvula de Ahmed adicionando mitomicina C en pacientes con glaucoma refractario a un año de seguimiento

Introduction

The Ahmed valve is indicated for glaucoma refractory to maximal pharmacologic therapy and properly performed filtering surgeries. Surgical success can be compromised by the formation of fibrotic tissue around the valve body; various strategies have been employed to prevent this, including the use of antimetabolites such as mitomycin C (MMC).

Aim

To evaluate the effectiveness and safety of mitomycin C (MMC) use when implanting Ahmed valve in patients with refractory glaucoma.

Methods

Cohort study involving 34 patients divided into 2 groups of 17 patients each: group 1 (MMC use) and group 2 (no MMC use), with a one-year follow-up. Complete success was defined as intraocular pressure (IOP) between 6-18 mmHg without the use of antiglaucoma medications; qualified success referred to the same IOP range but associated with antiglaucoma medications, while failure was characterized by IOP outside this range, severe complications or reintervention.

Results

The overall success rate in group 1 was 88.2%, and in group 2, 94.2%. There was an average reduction in IOP of 18.0 ± 11.5 mmHg in group 1 and 11.3 ± 5.0 mmHg in group 2 (p = 0.0352). The hypertensive phase occurred in 17.6% of the participants in the first group and the second, 70.6% (p = 0.0048).

Conclusions

The use of MMC decreases the hypertensive phase observed in Ahmed valve implant surgery, thereby achieving better IOP control.

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来源期刊

Archivos De La Sociedad Espanola De Oftalmologia Medicine-Ophthalmology

CiteScore

1.20

自引率

0.00%

发文量

109

审稿时长

78 days

期刊介绍： La revista Archivos de la Sociedad Española de Oftalmología, editada mensualmente por la propia Sociedad, tiene como objetivo publicar trabajos de investigación básica y clínica como artículos originales; casos clínicos, innovaciones técnicas y correlaciones clinicopatológicas en forma de comunicaciones cortas; editoriales; revisiones; cartas al editor; comentarios de libros; información de eventos; noticias personales y anuncios comerciales, así como trabajos de temas históricos y motivos inconográficos relacionados con la Oftalmología. El título abreviado es Arch Soc Esp Oftalmol, y debe ser utilizado en bibliografías, notas a pie de página y referencias bibliográficas.