康柏西普玻璃体内注射治疗白内障术后黄斑水肿的疗效观察

Effect observation of intravitreal injection of conbercept for macular edema after phacoemulsmcation surgery

目的观察玻璃体内注射康柏西普治疗白内障术后黄斑水肿的临床疗效。方法将2015-2017年就诊于我院眼科行白内障超声乳化吸出术后3个月仍存在黄斑水肿的患者58例(58眼)纳入本研究,并根据患者有无糖尿病史分为无糖尿病组(A组)14例(14眼)、有糖尿病但无糖尿病眼底病变组(B组)14例(14眼)及有糖尿病伴非增殖期糖尿病眼底病变组(C组)15例(15眼),三组患者均行康柏西普玻璃体内注射,同时设立对照组(未行玻璃体内注射药物治疗的黄斑水肿患者)15例15眼。观察治疗前及治疗后1个月、3个月、6个月的最佳矫正视力(best corrected visual acuity,BCVA)、眼压及黄斑中心凹厚度(central macular thickness,CMT)的改变。结果治疗前各组患者的BCVA及CMT差异均无统计学意义(均为P>0.05)。康柏西普玻璃体内注射治疗后1个月、3个月、6个月,A组、B组及C组的BCVA及CMT的改善程度较对照组显著好转,差异均有统计学意义(均有P<0.05);治疗后1个月A组CMT为(303.1±30.9)μm、B组CMT为(298.5±33.2)μm,治疗后3个月A组CMT为(244.6±24.8)μm、B组CMT为(255.9±29.2)μm,治疗后6个月A组CMT为(249.1±26.3)μm、B组CMT为(241.3±23.9)μm,差异均无统计学意义(均为P>0.05),但治疗后3个月、6个月C组CMT分别为(220.4±22.3)μm、(215.5±20.1)μm,与A、B组间差异均有统计学意义(均为P<0.05)。玻璃体内注药次数:A组为(2.61±0.87)次,B组为(2.57±0.94)次,C组为(2.73±0.96)次。各组患者治疗后均未见眼压异常升高及严重并发症出现。结论玻璃体内注射康柏西普能显著减轻白内障术后黄斑水肿,改善患者的视力,尤其是对合并糖尿病视网膜病变的患者疗效明显。

Objective To investigate the effects of intravitreal injection of Conbercept for macular edema after phacoemulsmcation surgery.Methods The analysis on the 58 patients （58 eyes） with macular edema after uncomplicated phacoemulsmcation surgery in our hospital from 2015 to 2017.And the 58 patients were randomly divided into group A,in which they were nondiabetic patients （14 patients eyes）,group B,in which who were diabetic patients but no diabetic retinopathy （14 patients 14 eyes）,and group C,in which who were diabetic retinopathy patients （15 patients 15 eyes）.All patients received intravitreal injection of conbercept.In addition,another 15 patients （15 eyes） with macular edema were collected as control group,and they were not treated with intravitreal injection of macular edema.The results were general analyzed,which included the best corrected visual acuity （BCVA）,the mean central macular retinal thickness（CMT）,and intraocular pressure（IOP）,and were compared in all groups before treatment and 1 month,3 months and 6 months after treatment.Results There was no significant difference in BCVA and CMT between the groups before treatment （all P 〉0.05）.The improvement of BCVA and CMT in group A,group B and group C was significantly better than that of the control group 1 month,3 months and 6 months after treatment.The differences were statistically significant （all P 〈0.05）.CMT in group A and group B was （303.1±30.9）μm and （298.5±33.2）μm one month after treatment,（244.6±24.8）μm and （255.9±29.2）μm 3 months after treatment,as well as （249.1±26.3） μm and （241.3±23.9）μm 6 months after treatment,with no significant difference （all P 〉0.05）.However,the CMT of the C group was （220.4±22.3） μm,（215.5±20.1）μm 3 months and 6 months after treatment,respectively,and there was a statistical difference between group A and C as well as group B and C （both P 〈0.05）.The number of injection was （2.61±0.87）times in the group A,（2.57±0.94）times in the group B,and （2.73±0.96）times in the group C.No abnormal increase in intraocular pressure and seriousness were observed in all groups after treatment.Conclusion Intravitreal injection of conbercept can improve visual acuity and capillary leakage in patients with macular edema after phaco-mulsmcation surgery,especially for patients with diabetic retinopathy.