Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Dirençli Pediatrik Glokom Olgularında Ahmed Glokom Valvi İmplantasyonunun Klinik Sonuçları: Retrospektif ve Gözlemsel Çalışma
Clinical Outcomes of Ahmed Glaucoma Valve Implantation in Refractory Pediatric Glaucoma Cases: Retrospective and Observational Study
Alev ÖZÇELİK KÖSEa, Buse ÖZ ONARa, Hatice TEKCANa, Yücel ÖZTÜRKa, Serhat İMAMOĞLUa, Süleyman KUĞUb
aSağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye
bMedistate Kavacık Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(3):140-4
doi: 10.5336/ophthal.2021-87789
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, dirençli pediatrik glokom olgularında Ahmed glokom valvi (AGV) implantasyonu sonuçlarımızı sunmaktır. Gereç ve Yöntemler: Bu retrospektif ve gözlemsel çalışmada, 2014-2018 tarihleri arasında Haydarpaşa Numune Eğitim ve Araştırma Hastanesi glokom biriminde AGV implantasyonu uygulanan dirençli pediatrik glokom hastalarının dosyaları incelendi. Hastaların medikal kayıtlarından yaş, cinsiyet, glokom tipi, eşlik eden oküler hastalık, daha önce geçirilen cerrahi tipi, eşlik eden konjenital anomaliler, düzeltilmiş en iyi görme keskinliği, biyomikroskobik ön segment muayenesi, göz içi basıncı (GİB) ölçümü, santral kornea kalınlığı, aksiyel uzunluk, goniyoskopi, optik disk ve fundus muayeneleri not edildi. Postoperatif her vizitteki GİB ve postoperatif komplikasyonlar kayıt edildi. Bulgular: Çalışmaya 16 hastanın 19 gözü (9 erkek, 7 kadın) dâhil edildi. Çocukların ortalama yaşı 9,82±6,08 idi. Postoperatif ortalama izlem süresi 4,3±1,66 yıldı. Ortalama GİB 1. yılda 16,1±2,84 mmHg, 2. Yılda 18,5±6,18 mmHg, 3. yılda 19,5±7,30 mmHg ve son vizitte 20,25±5,78 mmHg idi. Preoperatif GİB'e göre her vizitteki düşüş istatistiksel olarak anlamlı idi (p<0,05). Kümülatif başarı oranı 1. yılda %95, 2. Yılda %84 ve 5. yılın sonunda %47 idi. Sonuç: Dirençli pediatrik glokom tedavisinde, AGV implantasyonu uzun dönemde orta derecede başarı oranı göstermiştir. İlk 2 yıllık izlemde cerrahi başarı oranı yüksek iken 5. yılın sonunda bu oran %50'nin altına düşmektedir.

Anahtar Kelimeler: Ahmed glokom valvi; cerrahi başarı oranı; pediatrik glokom
ABSTRACT
 Objective: The purpose of this study was to present our results of Ahmed glaucoma valve (AGV) implantation in refractory pediatric glaucoma cases. Material and Methods: In this retrospective and observational study, the files of refractory pediatric glaucoma patients who underwent AGV implantation in the Haydarpaşa Numune Training and Research Hospital between 2014-2018 were reviewed. Medical records of the patients included age, gender, type of glaucoma, concomitant ocular disease, type of previous surgery, congenital anomalies, best corrected visual acuity, slit-lamp examination, intraocular pressure (IOP) measurement, central corneal thickness, axial length, gonioscopy, optic disc and fundus examination. Postoperative IOP and complications were recorded at each visit. Results: Nineteen eyes (9 men, 7 women) of 16 patients were included in this study. The mean age of the children was 9.82±6.08. The mean postoperative follow-up was 4.3±1.66 years. Mean IOP was 16.1±2.84 mmHg at 1 year, 18.5±6.18 mmHg at 2 year, 19.5±7.30 mmHg at 3 year, and 20.25±5.78 mmHg at last visit. The decrease of preoperative IOP at each visit was statistically significant (p<0.05). The cumulative success rate was 95% at 1 year, 84% at 2 year, and 47% at 5 year. Conclusion: The AGV implantation has a moderate long-term success rate in the management of refractory pediatric glaucoma. Although the surgical success rate of AGV implantation in the first 2 years of followup is high, it decreases below 50% at the end of the 5th year.

Keywords: Ahmed glaucoma valve; surgical success rate; pediatric glaucoma
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