玻璃体腔内注射Bevacizumab联合白内障手术治疗湿性年龄相关性黄斑变性(英文)

Intravitreal bevacizumab and cataract surgery after wet age-related macular degeneration

目的:探讨玻璃体腔内注射bevacizumab (Avastin)联合白内障手术预防脉络膜新生血管(choroidal neovascularization,CNV)的再次激活及年龄相关性黄斑变性(age-relatedmacular degeneration, AMD)。方法:对12例接受湿性年龄相关变性治疗的白内障患者给予透明角膜切口白内障超声乳化和人工晶状体植入手术,最后予以玻璃体腔内注射1.25mg bevacizumab (0.05mL)。主要评价指标:视力恢复、脉络膜新生血管的再次激活,及相干光断层成相术(OCT)对渗漏液体的评估。结果:患者最佳矫正视力(best-corrected visual acuity, BCVA)术后显著提高(脉络膜新生血管闭合后P<0.01,白内障发生后P=0.049,t检验)。白内障术后平均随访时间为11.8mo(标准差6.1,范围3 ～22mo),随访期内患者未出现脉络膜新生血管的再次激活及新的脉络膜新生血管病变。结论:在给予脉络膜新生血管及年龄相关性黄斑变性治疗的患者,白内障手术联合玻璃体腔内注射bevacizumab可预防脉络膜新生血管的再次激活。

AIM： To report the use of intravitreal bevacizumab associated with cataract surgery to prevent the re-activation of choroidal neovascularization （CNV） secondary to age-related macular degeneration （AMD）.METHODS： Twelve eyes from 12 patients who had been previously treated for wet AMD and presented cataracts were operated on by clear cornea phacoemulsification with intraocular lens implantation, and an intravitreal injection of 1.25mg （0.05mL） bevacizumab was performed by the end of the procedure. The results were evaluated in terms of visual acuity improvement and reactivation of CNV, as determined by the appearance of fluid in optical coherence tomography （OCT）. RESULTS： Best-corrected visual acuity（BCVA） significantly improved after surgery （P〈0.01 and P=0.049 for BCVA after CNV closure and BCVA after cataract development respectively, Student＇s t test for paired data）. Mean follow-up after cataract surgery was 11.8 months （SD 6.1, range 3 to 22 months）. CNV reactivation or appearance of new CNV lesions was not observed in any case during follow-up. CONCLUSION： Intravitreal bevacizumab immediately after cataract surgery may prevent CNV reactivation in patients previously treated from CNV secondary to AMD.