Afonso Murta, Edgar Lopes, Patrícia Silva, Catarina Barão, Maria Elisa Luís, Joana Cardigos, Teresa Gomes
{"title":"青光眼引流装置Ahmed ClearPath®250 mm2的临床结果和安全性:三级中心经验","authors":"Afonso Murta, Edgar Lopes, Patrícia Silva, Catarina Barão, Maria Elisa Luís, Joana Cardigos, Teresa Gomes","doi":"10.18240/ijo.2025.10.12","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To present the clinical outcomes in efficacy and safety of the Ahmed ClearPath® (ACP) 250 mm<sup>2</sup> model as well as our surgical technique.</p><p><strong>Methods: </strong>Single-center prospective interventional study of uncontrolled glaucoma eyes undergoing ACP implantation, as a standalone procedure or in combination with cataract phacoemulsification. Intraocular pressure (IOP) was evaluated prior to surgery and 1wk, 1, 3, 6mo and 1y postoperatively. In addition, the number of antiglaucoma drugs and intra and postoperative complications were assessed.</p><p><strong>Results: </strong>A total of 30 eyes of 28 patients were included in the study. The patients were on average 72.8 (13.4) years old and 53.6% were male. Totally 40% of the eyes had primary open angle glaucoma, 16.7% had neovascular glaucoma, 16.7% had pseudoexfoliative glaucoma, 10% had glaucoma secondary to pars plana vitrectomy with silicone oil tamponade, 6.7% had aphakic glaucoma, 6.7% had primary congenital glaucoma and 3.3% had pigmentary glaucoma. Before surgery mean IOP was 26.1 (10.8) mm Hg and mean glaucoma medication use was 3.7 (0.5). At 1, 3, 6 and 12mo mean IOP was 16.1, 11.7, 11.8 and 11.5 mm Hg, respectively. Mean glaucoma medication use was 1.9, 1.5, 1.2 and 1.2, respectively. At 1y, complete surgical success was found in 46.7% patients (<i>n</i>=14) and qualified success in 53.3% (<i>n</i>=16). There were no intraoperative complications. Postoperative complications include choroidal effusion (<i>n</i>=5), transient hyphema (<i>n</i>=2), early hypotony with shallow anterior chamber (<i>n</i>=2) and late hemorrhagic choroidal detachment (<i>n</i>=1).</p><p><strong>Conclusion: </strong>The ACP appears to be an efficient surgical option for treating refractory glaucoma, achieving good IOP control and decreasing medication burden. The results obtained at 6mo are an important prognostic factor for long-term outcomes.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"18 10","pages":"1901-1907"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454008/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical outcomes and safety profile of glaucoma drainage device Ahmed ClearPath® 250 mm<sup>2</sup>: a tertiary center experience.\",\"authors\":\"Afonso Murta, Edgar Lopes, Patrícia Silva, Catarina Barão, Maria Elisa Luís, Joana Cardigos, Teresa Gomes\",\"doi\":\"10.18240/ijo.2025.10.12\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To present the clinical outcomes in efficacy and safety of the Ahmed ClearPath® (ACP) 250 mm<sup>2</sup> model as well as our surgical technique.</p><p><strong>Methods: </strong>Single-center prospective interventional study of uncontrolled glaucoma eyes undergoing ACP implantation, as a standalone procedure or in combination with cataract phacoemulsification. Intraocular pressure (IOP) was evaluated prior to surgery and 1wk, 1, 3, 6mo and 1y postoperatively. In addition, the number of antiglaucoma drugs and intra and postoperative complications were assessed.</p><p><strong>Results: </strong>A total of 30 eyes of 28 patients were included in the study. The patients were on average 72.8 (13.4) years old and 53.6% were male. Totally 40% of the eyes had primary open angle glaucoma, 16.7% had neovascular glaucoma, 16.7% had pseudoexfoliative glaucoma, 10% had glaucoma secondary to pars plana vitrectomy with silicone oil tamponade, 6.7% had aphakic glaucoma, 6.7% had primary congenital glaucoma and 3.3% had pigmentary glaucoma. Before surgery mean IOP was 26.1 (10.8) mm Hg and mean glaucoma medication use was 3.7 (0.5). At 1, 3, 6 and 12mo mean IOP was 16.1, 11.7, 11.8 and 11.5 mm Hg, respectively. Mean glaucoma medication use was 1.9, 1.5, 1.2 and 1.2, respectively. At 1y, complete surgical success was found in 46.7% patients (<i>n</i>=14) and qualified success in 53.3% (<i>n</i>=16). There were no intraoperative complications. Postoperative complications include choroidal effusion (<i>n</i>=5), transient hyphema (<i>n</i>=2), early hypotony with shallow anterior chamber (<i>n</i>=2) and late hemorrhagic choroidal detachment (<i>n</i>=1).</p><p><strong>Conclusion: </strong>The ACP appears to be an efficient surgical option for treating refractory glaucoma, achieving good IOP control and decreasing medication burden. The results obtained at 6mo are an important prognostic factor for long-term outcomes.</p>\",\"PeriodicalId\":14312,\"journal\":{\"name\":\"International journal of ophthalmology\",\"volume\":\"18 10\",\"pages\":\"1901-1907\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454008/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18240/ijo.2025.10.12\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18240/ijo.2025.10.12","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:介绍Ahmed ClearPath®(ACP) 250 mm2模型以及我们的手术技术的有效性和安全性的临床结果。方法:对未控制青光眼行ACP植入术,单独或联合白内障超声乳化术的单中心前瞻性介入研究。分别于术前、术后1周、1周、3周、6月和1月评估眼内压。此外,还评估了抗青光眼药物的使用数量以及手术内和术后并发症的发生情况。结果:28例患者共30只眼纳入研究。患者平均年龄72.8岁(13.4岁),男性53.6%。原发性开角型青光眼占40%,新生血管性青光眼占16.7%,假剥脱性青光眼占16.7%,玻璃体平面肌切除术合并硅油填塞继发青光眼占10%,无晶状体青光眼占6.7%,原发性先天性青光眼占6.7%,色素性青光眼占3.3%。术前平均IOP为26.1 (10.8)mm Hg,平均青光眼用药3.7(0.5)。在1、3、6和12个月时,平均IOP分别为16.1、11.7、11.8和11.5 mm Hg。平均青光眼药物使用率分别为1.9、1.5、1.2和1.2。1岁时,46.7%的患者(n=14)手术完全成功,53.3%的患者(n=16)手术成功。无术中并发症。术后并发症包括脉络膜积液(n=5),一过性前房积血(n=2),早期低斜视伴浅前房(n=2)和晚期出血性脉络膜脱离(n=1)。结论:ACP是治疗难治性青光眼的一种有效的手术选择,能很好地控制眼压,减轻药物负担。6个月时获得的结果是长期预后的重要预后因素。
Clinical outcomes and safety profile of glaucoma drainage device Ahmed ClearPath® 250 mm2: a tertiary center experience.
Aim: To present the clinical outcomes in efficacy and safety of the Ahmed ClearPath® (ACP) 250 mm2 model as well as our surgical technique.
Methods: Single-center prospective interventional study of uncontrolled glaucoma eyes undergoing ACP implantation, as a standalone procedure or in combination with cataract phacoemulsification. Intraocular pressure (IOP) was evaluated prior to surgery and 1wk, 1, 3, 6mo and 1y postoperatively. In addition, the number of antiglaucoma drugs and intra and postoperative complications were assessed.
Results: A total of 30 eyes of 28 patients were included in the study. The patients were on average 72.8 (13.4) years old and 53.6% were male. Totally 40% of the eyes had primary open angle glaucoma, 16.7% had neovascular glaucoma, 16.7% had pseudoexfoliative glaucoma, 10% had glaucoma secondary to pars plana vitrectomy with silicone oil tamponade, 6.7% had aphakic glaucoma, 6.7% had primary congenital glaucoma and 3.3% had pigmentary glaucoma. Before surgery mean IOP was 26.1 (10.8) mm Hg and mean glaucoma medication use was 3.7 (0.5). At 1, 3, 6 and 12mo mean IOP was 16.1, 11.7, 11.8 and 11.5 mm Hg, respectively. Mean glaucoma medication use was 1.9, 1.5, 1.2 and 1.2, respectively. At 1y, complete surgical success was found in 46.7% patients (n=14) and qualified success in 53.3% (n=16). There were no intraoperative complications. Postoperative complications include choroidal effusion (n=5), transient hyphema (n=2), early hypotony with shallow anterior chamber (n=2) and late hemorrhagic choroidal detachment (n=1).
Conclusion: The ACP appears to be an efficient surgical option for treating refractory glaucoma, achieving good IOP control and decreasing medication burden. The results obtained at 6mo are an important prognostic factor for long-term outcomes.
期刊介绍:
· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online).
This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from
WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed,
PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166.
IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific
Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO);
Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President,
Chinese Academy of Engineering.
International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of
blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of
AAO/PAAO) et al.
Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of
Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and
Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society).
Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press).
Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and
Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics).
Associate Editors-in-Chief include:
Prof. Ning-Li Wang (President Elect of APAO);
Prof. Ke Yao (President of Chinese Ophthalmological Society) ;
Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ;
Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA);
Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society);
Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA);
Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA).
IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles,
both basic and clinical papers.
Instruction is Welcome Contribution is Welcome Citation is Welcome
Cooperation organization
International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.