玻璃体腔内注射Avastin联合睫状体光凝治疗新生血管性青光眼

Intravitreal injection of Avastin combined with cyclophotocoagulation for neovascular glaucoma

目的观察玻璃体腔内注射Avastin联合睫状体光凝治疗新生血管性青光眼的临床效果。方法 16例(16眼)虹膜新生血管性青光眼患者给予玻璃体腔内注射25 g.L-1Avastin 0.05 mL,并联合睫状体光凝治疗。术后随访6个月,观察术后眼压、视力、虹膜新生血管及并发症情况。结果 16例虹膜新生血管性青光眼患者在玻璃体腔内注射Avastin后3 d内新生血管消退。睫状体光凝治疗后3 d平均眼压为(22.4±3.2)mmHg(1 mmHg=0.133 kPa),1周为(19.3±2.5)mmHg,1个月为(19.2±1.7)mmHg,6个月为(18.7±1.4)mmHg,与治疗前(52.1±6.5)mmHg比较,差异均有统计学意义(P<0.05)。治疗前后视力比较差异无统计学意义(P>0.05)。随访期间未发现眼内炎、视网膜脱离、玻璃体积血等并发症。结论玻璃体腔内注射Avastin联合睫状体光凝可作为治疗新生血管性青光眼的重要方法。

Objective To observe the clinical effect of intravitreal injection of Avastin combined with cyclophotocoagulation in treatment of neovascular glaucoma.Methods Sixteen iris neovascular glaucoma patients（16 eyes）were given intravitreal injection of 25 g·L-1 Avastin 0.05 mL,and accepted cyclophotocoagulation.After a follow-up of 6 months,the postoperative intraocular pressure（IOP）,visual acuity,iris neovascularization and complications were observed.Results The iris neovascularization in all patients subside within 3 days after injection of Avastin.The average IOP was（22.4± 3.2）,（19.3±2.5）,（19.2±1.7） and（18.7±1.4） mmHg（1 mmHg=0.133 kPa） at 3 days,1 week,1 month,and 6 months respectively after cyclophotocoagulation.The average IOP was（52.1±6.5）mmHg before treatment.There were statistic difference in average IOP after cyclophotocoagulation compared with before treatment（P0.05）.There were no significant difference of visual acuity before and after treatment（P0.05）.The endophthalmitis,retinal detachment,vitreous hemorrhage and other complications were not found during the follow-up period.Conclusion Intravitreal injection of Avastin combined with cyclophotocoagulation can be used as an important method for neovascular glaucoma.