Ranibizumab玻璃体腔注射联合玻璃体切割治疗合并新生血管性青光眼的PDR

Intravitreal ranibizumab assisted pars plana virectomy treating proliferative diabetic retinopathy combined neovescular glaucoma

目的探讨Ranibizumab玻璃体腔注射联合玻璃体切割治疗合并新生血管性青光眼（NVG）的增殖性糖尿病视网膜病变（PDR）的效果。方法对合并Ⅰ期、Ⅱ期NVG的PDR13例13只眼，玻璃体腔内注入0．5mg（0．05ml）的Ranibizumab后5～7d行玻璃体切割术。结果Ranibizumab玻璃体腔注射后5～7d，13例患者虹膜、房角新生血管明显消退；注药前、后平均眼压比较差异无统计学意义；手术后1周平均眼压与术前相比，差异无统计学意义；术后6个月平均眼压较手术前眼压降低，差异有统计学意义（P〈0．05）。9只眼（69．2％）手术后视力较手术前有不同程度提高，4只眼（30．8％）手术后视力无改善；玻璃体注药及手术后无l例发生眼内炎。结论Ranibizumab玻璃体腔预注射联合玻璃体切割术在治疗合并Ⅰ期、Ⅱ期NVG的PDR中有较好的效果．可挽救部分有用视力。

OBJECTIVE To study the clinical therapeutic effects and complications of intravitreal ranibizumab assisted pars plana virectomy （PPV） for the treatment of proliferative diabetic retinopathy （PDR） combined neoveseular glaucoma （NVG）. METHODS The study included 13 cases （13 eyes） underwent PPV for the treatment of PDR combined NVG. They received an intravitreal injection of 0.5mg ranibizumab 5 to 7 clays before operation. RESULTS Iris neovascularization after treatment disappeared in different degrees. The difference of the mean intraocular pressure was not statistically significant after intravitreal ranibizumab; during one week after operation, the difference was not statistically significant between the mean preoperative and postoperative intraocular pressure. After 6 months, the mean intraoeular pressure was lower than preoperative, the difference was statistically significant. The postoperative visual acuity was improved in 9 eyes. No obvious complication appeared in all patients. CONCLUSIONS Intravitreal ranibizumab assisted PPV for the treatment of PDR combined NVG was useful with no serious complications.