在一个具有挑战性的情况下处理反复的管暴露

M. Menon, Aditi Singh, Anand Balasubramaniyam
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引用次数: 1

摘要

用四根9/0尼龙缝合线固定在管子上。青光眼引流装置(GDD)仍然是治疗难治性青光眼的有效选择。然而,GDD手术并非没有并发症,包括结膜糜烂和移植片变薄,仅举几例,最终导致管暴露。在我们的病例中,患者有多种眼部暴露的危险因素,因此我们使用多种治疗方案来防止复发暴露和随后的并发症。一位42岁的女士,在钝器外伤后右眼视力突然下降。经检查,发现右眼视网膜脱离。她接受了视网膜脱离手术和360度巩膜屈曲。手术后,她患上了顽固性青光眼,在巩膜扣去除后植入了Ahmed青光眼瓣膜。她有两次导管暴露。第一个是通过直接的结合体来处理的。第二种是巩膜片移植,巩膜片覆盖下穹窿结膜,并在其上固定羊膜。给予强力霉素片剂100mg /天,疗程2个月。手术后一年半,眼压控制良好,再无管暴露事件发生。分流手术后引流管的腐蚀是一个潜在的严重问题。虽然许多技术和材料已经成功地用于解决这种情况,但需要进一步的研究来确定最佳的修复方法。摘要医学治疗。Ahmed青光眼瓣膜;模型FP7 (New World Medical, LA)在去除巩膜扣后植入右眼
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Management of Recurrent Tube Exposure in A Challenging Scenario
secured over the tube with four 9/0 nylon interrupted buried sutures. A 6×4-mm-free conjunctival autograft was obtained Glaucoma drainage devices (GDD) remain an effective option for management of refractory glaucoma. However, GDD surgery is not without its complications, including conjunctival erosion and patch graft thinning, to name a few, leading to tube exposure eventually. In our case the patient had various ocular risk factors for tube exposure, thus we used multiple treatment options to prevent recurrent exposure and subsequent complications. A 42 year old lady presented with complaint of sudden decrease in right eye vision, following blunt trauma. On examination, she was found to have retinal detachment in the right eye. She underwent retinal detachment surgery with 360o scleral buckling. She developed intractable glaucoma following surgery, for which Ahmed Glaucoma Valve was implanted after scleral buckle removal. She had two instances of tube exposure. The first was managed with direct conjuctival closure. For the second, a scleral patch graft was used, which was covered with conjunctiva from the inferior fornix and amniotic membrane secured over it. She was on a course of tablet doxycycline 100mg / day, for 2 months. One and a half years after surgery there are no further incidents of tube exposure with well controlled intraocular pressure. Erosion of the drainage tube after shunt surgery is a potentially serious problem. While many techniques and materials are successfully used to address this situation, further studies are required to determine the best repair method. Abstract medical therapy. An Ahmed glaucoma valve (AGV; model FP7, New World Medical, LA) was implanted in the right eye after scleral buckle removal to
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