아메드밸브삽입술 후 발생한 악성녹내장 2예
Two Cases of Malignant Glaucoma after Ahmed Valve Implantation
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목적: 아메드밸브삽입술을 시행한 환자들에서 악성녹내장을 경험하였기에 이를 보고하고자 한다. 증례요약: (증례 1) 우안 폐쇄각녹내장이 있는 76세 여자 환자에서 아메드밸브삽입술을 시행하였다. 각막부전을 우려하여 아메드밸브튜브를 섬모체고랑 내에 위치시켰다. 술 후 8일째, 얕은 전방과 안압상승으로 수술적 홍채절제술을 시행하였다. 술 후 3주째 안압상승및 전방소실로 유리체절제술을 시행하였고, 반복적 안압상승이 있어 아메드밸브 튜브를 유리체강 내로 재위치 시킨 후 안압이 조절되었다. (증례 2) 거짓비늘녹내장이 있는 93세 여자 환자에게 좌안 아메드밸브삽입술 시행 후 5일째 안압상승 및 전방소실, 전방 내수정체 피질과 탈출된 유리체가 관찰되었다. 전방세척과 수술적 홍채절제술을 시행했으나 술 후 1개월 안압 재상승 및 전방소실로앞유리체절제술을 시행하였다. 결론: 아메드밸브삽입술 후 악성녹내장이 생기는 경우는 매우 드물다. 짧은 안축장, 약한 섬모체소대, 고령, 여성 등의 위험요소가공존하는 경우, 아메드밸브삽입술 후 악성녹내장의 발생 가능성이 높아질 수 있어 주의해야 한다.
Abstract
Purpose: To report two cases of malignant glaucoma after Ahmed valve implantation. Case summary: (Case 1) A 76-year-old female with angle closure glaucoma in the right eye underwent Ahmed valve implantation. To reduce the risk of corneal endothelial failure, the tube tip was located in the sulcus. Eight days after surgery, surgical iridectomy was performed due to intraocular pressure elevation and a shallow anterior chamber. Three weeks later, vitrectomy was performed due to intraocular pressure elevation with a shallow anterior chamber. Recurrent intraocular pressure elevation was resolved after tip reposition into the vitreous cavity. (Case 2) A 93-year-old female with pseudoexfoliation glaucoma underwent Ahmed valve implantation in the left eye. Five days after surgery, the intraocular pressure increased with a shallow anterior chamber; the remnant cortex and prolapsed vitreous body were present in the anterior chamber. She underwent anterior chamber washing and surgical iridectomy; however, the increase in intraocular pressure with a shallow anterior chamber worsened after 1 month; thus, anterior vitrectomy was performed. Conclusions: Malignant glaucoma after Ahmed valve implantation is considered very rare. However, if risk factors such as short axial length, zonular weakness, old age, or female gender are present, as in these cases, there may be an increased risk of malignant glaucoma developing after Ahmed valve implantation.
참고문헌 (16)
- von Graefe A, "Beltrage zur patholoogie and therapie des glaucomas. Albrecht von Graefe", Arch Ophthalmol, 15 (1869)
- Foreman-Larkin J, "Clinical management of malignant glaucoma", J Ophthalmol, 2015, pp.283707~ (2015)
- Krix-Jachym K, "Risk factors of malignant glaucoma occurrence after glaucoma surgery", J Ophthalmol, 2017, pp.9616738~ (2017)
- Lee SY, "Evaluating anterior segment structure using anterior segment optical coherence tomography in malignant glaucoma after Ahmed valve implantation", Med case rep study protoc, 1, pp.e0006~ (2020)
- Martínez-de-la-Casa JM, "Malignant glaucoma following combined Ahmed valve implant and phacoemulsification surgery for chronic angle-closure glaucoma", Arch Soc Esp Oftalmol, 80, pp.667~670 (2005)
- Byrnes GA, "Vitrectomy for ciliary block(malignant)glaucoma", Ophthalmology, 102, pp.1308~1311 (1995)
- Schwartz AL, "Malignant glaucoma"in an eye with no antecedent operation or miotics", Arch Ophthalmol, 93, pp.379~381 (1975)
- Grzybowski A, "Acute and chronic fluid misdirection syndrome : pathophysiology and treatment", Graefes Arch Clin Exp Ophthalmol, 256, pp.135~154 (2018)
- Balekudaru S, "Surgical management of malignant glaucoma : a retrospective analysis of fifty eight eyes", Eye(Lond), 31, pp.947~955 (2017)
- Luntz MH, "Malignant glaucoma", Surv Ophthalmol, 32, pp.73~93 (1987)
- Varma DK, "Malignant glaucoma after cataract surgery", J Cataract Refract Surg, 40, pp.1843~1849 (2014)
- Dave P, "Treatment outcomes in malignant glaucoma", Ophthalmology, 120, pp.984~990 (2013)
- Bitrian E, "Pars plana anterior vitrectomy, hyaloido-zonulectomy, and iridectomy for aqueous humor misdirection", Am J Ophthalmol, 150, pp.82~87 (2010)
- Wishart PK, "Ahmed glaucoma valves in refractory glaucoma : a 7-year audit", Br J Ophthalmol, 94, pp.1174~1179 (2010)
- Gedde SJ, "Postoperative complications in the tube versus trabeculectomy(TVT)study during five years of follow-up", Am J Ophthalmol, 153, pp.804~814 (2012)
- Riva I, "A review of the Ahmed glaucoma valve implant and comparison with other surgical operations", Adv Ther, 34, pp.834~847 (2017)