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실명한 녹내장안에서 통증 조절을 위해 시행한 녹내장 수술의 경과

Other Titles
 Glaucoma Surgery in Patients with Painful Blind Glaucomatous Eyes 
Authors
 강은민  ;  이윤하  ;  서상진  ;  김찬윤  ;  성공제  ;  홍사민 
Citation
 JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY, Vol.55(10) : 1511-1519, 2014 
Journal Title
 JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 
ISSN
 0378-6471 
Issue Date
2014
Keywords
Ahmed glaucoma valve ; Glaucoma ; Painful blind eye ; Sympathetic ophthalmia ; Trabeculectomy
Abstract
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.
Files in This Item:
T201404093.pdf Download
DOI
10.3341/jkos.2014.55.10.1511
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chan Yun(김찬윤) ORCID logo https://orcid.org/0000-0002-8373-9999
Seo, Sang Jin(서상진)
Seong, Gong Je(성공제) ORCID logo https://orcid.org/0000-0002-5456-4296
Lee, Yun Ha(이윤하)
Hong, Sa Min(홍사민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100336
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