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玻璃体内注射雷珠单抗联合引流器植入及视网膜光凝术治疗新生血管性青光眼 被引量:6

Intravitreal injection of Ranibizumab combined with Ex-Press implantation and panretinal photocoagulafion for neovascular glaucoma
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摘要 目的评价玻璃体内注射雷珠单抗联合Ex—Press引流器植入术及广泛视网膜光凝术治疗新生血管性青光眼的效果。方法收集回顾性分析2015年3月至2017年1月39例(39眼)新生血管性青光眼的临床资料。患者曾随机分为两组,A组采用玻璃体内注射雷珠单抗+Ex—Press引流器植入+视网膜光凝术,B组采用玻璃体内注射雷珠单抗+小梁切除+视网膜光凝术进行治疗,对两组术前及术后6个月时视力,术前及术后1、3及6个月时的眼压、虹膜新生血管变化、手术成功率及并发症等资料进行分析。结果术前及术后6个月两组之间BCVA比较,差异均无统计学意义(P〉0.05),两组术后BCVA较术前BCVA明显提升,差异有统计学意义(χ^2=11.183,12.961,P=0.011,0.005)。两组术后1、3及6个月眼压均较术前下降,差异有统计学意义(P〈0.05),两组间术前及术后1、3及6个月眼压比较,差异均无统计学意义(t=0.041,-1.457,0.091,0.153,P〉0.05)。两组手术成功率相比差异无统计学意义(χ^2=0.550,P=0.458)。B组手术并发症发生率较A组高,差异有统计学意义(χ^2=4.353,P=0.037)。结论玻璃体内注射雷珠单抗分别联合Ex—Press引流器植入术及视网膜光凝术治疗新生血管性青光眼是安全有效的,且并发症较少。 Objective To evaluate the clinical efficacy of intravitreal Ranibizumab injection combined with Ex-Press implantation and panretinal photocoagulation for neovascular glaucoma. Methods The data of 39 eyes of 39 cases with neovascular glaucoma from Mar. 2015 to Jan. 2017 were collected and analyzed retrospectively. The patients had been randomly divided into two groups: the research group, 21 cases, were treated with Ranibizumab intravitreal injection combined with Ex-Press implantation ; the control group, 18 cases, were treated with Ranibizumab intravitreal injection combined with trabeculectomy and panretinal photocoagulation. The visual acuity, intraocular pressure, iris neovascular vessels, the operation successful rate and complications in both groups before and 1, 3, 6 months after surgery were observed and analyzed. Results The difference in BCVA before and 6 months after surgery were not statistically significant between two groups( P 〉0.05 ). The postoperative BCVA of two groups were improved, the difference was statistically significant between before and after surgery(χ^2 = 11. 183, 12. 961, P = 0.011,0.005). The intraocular pressure after surgery were decreased in two groups, the difference wasstatistically significant between before and after surgery ( P 〈 0.05 ). The difference of intraocular pressure before and after sugery were not statistically significent between two groups (t =0.041 ,-1. 457,0. 091,0. 153, P 〉0.05). The difference of operation successful rate were not statistically significant between two groups (χ^2 = 0. 550, P = 0. 458 ). The incidence of complications of group B was higer than that of group A, the difference was statistically significant between the two groups (χ^2 = 4.353,P = 0.037) . Conclusion Ex-Press implantation or trabeculectony combined with intravitreal ranibizumab injection and after surgery panretinal photocoagulation for NVG is safe and effective. The complications are less.
出处 《中华眼外伤职业眼病杂志》 2018年第2期117-120,共4页 Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词 青光眼 新生血管性 Ex-Press引流器植入术 雷珠单抗 玻璃体内注射 光凝 广泛视网膜 Glaucoma, neovascular Ex-Press implantation Ranibizumab, intravitreal injection photocoagulation, panretinal
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