실명한 녹내장안에서 통증 조절을 위해 시행한 녹내장 수술의 경과

• 영문명: Glaucoma Surgery in Patients with Painful Blind Glaucomatous Eyes
• 발행기관: 대한안과학회
• 저자명: 강은민 이윤하 서상진 김찬윤 성공제 홍사민,Eun Min Kang, MD, Yun Ha Lee, MD, Sang Jin Seo, MD, Chan Yun Kim, MD, PhD, Gong Je Seong, MD, PhD, Samin Hong, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume55,number10, 1511~1519쪽, 전체 9쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2014.10.15

영문 초록

Purpose: To investigate the clinical outcome of glaucoma surgery performed in patients with painful blind glaucomatous eyes. Methods: A single-center, retrospective, interventional case series was performed by reviewing the medical records of 74 glaucoma patients (74 eyes) who underwent Ahmed glaucoma valve (AGV) implantation or trabeculectomy for painful blind eyes from October 2004 to January 2014. Blindness was defined as visual acuity less than hand motion at the time of surgery. Preoperative and postoperative intraocular pressure (IOP), number of anti-glaucoma medications, and presence of pain were compared in the patients grouped according to the type of glaucoma surgery. The glaucoma type, history of previous glaucoma surgery and postoperative failure/complications were also evaluated. Results: AGV implantation was performed in 42 eyes (56.8%) of 42 patients, and trabeculectomy was performed in 32 eyes (43.2%) of 32 patients. The average IOP decreased from 41.73 ± 11.77 mm Hg before surgery to 14.29 ± 9.34 mm Hg at five years after the surgery (p < 0.001, paired t-test). The IOP was not significantly different between the groups at any follow-up time point (p = 0.949, linear mixed model). Overall, three patients (4.1%) still experienced eye pain after surgery, IOP greater than 30 mm Hg was observed in eight eyes (10.8%), and additional surgery was required in 11 eyes (14.9%). Evisceration was required in only two eyes (2.7%). Sympathetic ophthalmia was not found in any patient during the follow-up period. Conclusions: Glaucoma surgery including AGV implantation/trabeculectomy was effective and safe even for painful blind eyes. The procedure may be considered as an alternative to enucleation as an initial surgical option for painful blind glaucomatous eyes. J Korean Ophthalmol Soc 2014;55(10):1511-1519

키워드

Ahmed glaucoma valve, Glaucoma, Painful blind eye, Sympathetic ophthalmia, Trabeculectomy