复合式小梁切除术联合康柏西普治疗新生血管性青光眼

Compound trabeculectomy with conbercept for neovascular glaucoma

目的观察复合式小梁切除术联合康柏西普对新生血管性青光眼的疗效。方法 56例(56眼)新生血管性青光眼患者根据治疗方法不同分为A组和B组,A组给予康柏西普玻璃体内注射后行复合式小梁切除术,B组给予睫状体冷凝术治疗。对两组患者术后视力、眼压、手术成功率和并发症情况进行观察,并进行统计学分析。结果术后1个月,A组视力提高者10眼(35.7%),不变者16眼(57.1%),下降者2眼(7.2%);B组视力提高者3眼(10.7%),不变者17眼(60.7%),下降者8眼(28.6%);两组视力提高率间差异有统计学意义(P<0.05),A组视力提高率较B组高。A组手术成功率为92.9%,显著高于B组(78.6%),差异有统计学意义(P<0.05)。两组术后1 d、2周、3个月眼压与术前相比均显著下降,差异均有统计学意义(均为P<0.05);术前两组眼压差异无统计学意义(P>0.05),术后各时间点两组眼压比较差异均有统计学意义(均为P<0.05),A组均显著低于B组。A组并发症发生率为21.4%,显著低于B组(75.0%),差异有统计学意义(P<0.05)。结论复合式小梁切除术联合康柏西普治疗新生血管性青光眼疗效好、并发症少、安全性高。

Objective To observe the clinical effects of compound trabeculectomy with conbercept for neovascular glaucoma. Methods A total of 56 patients （56 eyes） with neovasctflar glaucoma were divided into two groups： Group A （ observation group） and group B （control group ）, by random number method. The observation group was treated with compound trabeculectomy and conbercept. Control group was treated with cyclocryotherapy. The changes on visual acuity, intraocular pressure （IOP） and complication were observed after operation. Results Postoperative visual acuity at 1 month improved in 10 eyes （35.7%） in group A,which was significantly more than that in group B （3 eyes, 10.7% ） （P 〈 0.05 ） ;And decreased in 2 eyes （7.2%） in group A, which was significantly less than that in group B （ 8 eyes, 28.5% ） （ P 〈 0.05 ）. The Successful rate in group A and B were 92.9% and 78.5% ,respectively,there was statistical difference （P 〈 0.05 ）. At the postoperative 1 day, 2 weeks and 3 months, IOP in two groups decreased significantly and there were statistical differences compared with that before treatment （ all P 〈 0.05 ）. The incidence of complication in group A was 21.4% , which was significantly lower than that of group B （75.0%） （P 〈 0.05 ）. Conclusion Compound trabeculectomy with conbercept for neovascular glaucoma can improve visual acuity, reduce IOP, and relieve symptoms with high safety.