玻璃体腔注射Lucentis辅助治疗新生血管性青光眼

Efficacy of adjunctive intravitreous injection with Lucentis for neovascular glaucoma

目的：观察玻璃体腔注射Lucentis在治疗新生血管性青光眼（NVG）中的作用。方法：回顾性系列病例分析。25例25眼NVG患者接受玻璃体腔Lucentis 注射（ranibizumab 0.5mg/0.05mL），待虹膜新生血管消退后，根据病情采用不同治疗方式。术后观察虹膜及房角新生血管情况、眼压及视力变化，随访3mo。结果：玻璃体腔注射Lucentis 3～7d后，20例20眼虹膜和房角新生血管完全消退，5例5眼7d后新生血管未完全消退。继续治疗情况如下：复合式小梁切除术14例14眼，玻璃体切割术4例4眼。患者治疗前平均眼压为43.42±10.99mmHg，出院时平均眼压明显下降（14.26±7.64mmHg， P〈0.05），并且在随访3mo时保持稳定（18.76±5.96mmHg，P〈0.05）。随访3mo时，视力较前提高和不变者20眼，视力下降者5眼。手术完全成功21眼，部分成功3眼，失败为1眼。 结论：璃体腔注射Lucentis，可作为治疗NVG的辅助方法，根据不同病情联合其他治疗方法，可有效治疗NVG。

AIM： To observe the clinical efficacy of adjunctive intravitreous injection with Lucentis for the treatment of neovascular glaucoma（NVG）. METHODS： The retrospective case series study included 25 eyes of 25 patients who underwentintravitreous injection with Lucentis. Patients firstly received an intravitreous injection with Lucentis（0.5mg/0.05mL）, after the regression of neovascularization of the iris, patients accepted different surgical treatments according to different etiopathogenesis condition. Iris, chamber angle neovascularization condition, intraocular pressure, and visual acuity were observed postoperatively. The follow-up duration was 3mo.RESULTS： After 3-7d of intravitreous Lucentis injecting, iris and chamber angle neovascularization was totally faded in 20 cases（20 eyes）and was not completely faded in 5 cases（5 eyes）. Additional treatments were compound trabeculectomy（14 cases, 14 eyes）, vitrectomy（4 cases, 4 eyes）. The patients＇ mean intraocular pressure was 43.42±10.99mmHg before treatment, which decreased rapidly when they came out of the hospital（14.26±7.64mmHg, P〈0.05）and stabilized during the follow-up 3mo（18.76±5.96mmHg, P〈0.05）. Follow-up at 3mo, visual acuity improved or remained in 20 cases（20 eyes）and decreased in 5 cases（5 eyes）. The complete success, qualified success and failure were 21 eyes, 3 eyes and 1 eye, respectively.CONCLUSION：Intravitreous injection with Lucentis can be used as an assisted treatment of NVG. According to different etiopathogenesis condition, it is an effective treatment to combine with other treatment methods for NVG.