抗血管内皮生长因子联合Ahmed引流阀植入术治疗新生血管性青光眼

Anti-VEGF combined Ahmed drainage valve implantation for neovascular glaucoma

目的观察玻璃体腔注射抗血管内皮生长因子(VEGF)及Ahmed青光眼引流阀植入治疗新生血管性青光眼(NVG)患者的远期疗效及并发症。方法回顾性分析福州总医院收治的NVG患者19例20眼,13眼行玻璃体腔注射抗VEGF及Ahmed青光眼引流阀植入联合玻璃体切除术(PPV),术中行全视网膜光凝术(PRP);另7眼行玻璃体腔注射抗VEGF及Ahmed青光眼引流阀植入术,术后根据眼底血管荧光造影情况对血管无灌注区行激光光凝术。观察19例患者术中和术后并发症,分别观察术后1周、1个月、3个月、6个月、12个月时的眼压、视力、虹膜新生血管生长及降眼压药物使用情况。结果 20眼术前平均眼压值为(45.00±3.60)mm Hg,术后1周、1个月、3个月、6个月、12个月随访时的平均眼压值分别为(12.00±2.21)、(15.20±1.79)、(16.52±1.35)、(17.28±3.17)、(19.00±2.31)mm Hg,治疗后各随访时间点眼压较治疗前差异具有统计学意义(P<0.05)。结论玻璃体腔内注射抗VEGF后植入Ahmed青光眼引流阀联合视网膜激光光凝术对新生血管性青光眼治疗有效,并能有效控制患者的眼压。

ObjectiveTo evaluate the effect of intravitreal anti-VEGF injection and Ahmed glaucoma valve(AGV)implantation in patients with neovascular glaucoma(NVG)eyes.MethodsThis retrospective study included 19 NVG patients(20 eyes)who underwent AGV implantation.Panretinal laser photocoagulation was performed for 13 eyes with NVG who underwent intravitreal anti-VEGF injection and Ahmed glaucoma valve(AGV)implantation.The other patients underwent fluorescein angiography of the fundus and retinal laser photocoagulation on the non-perfusion area after Ahmed glaucoma valve(AGV)implantation and intravitreal injection VEGF.ResultsMean intraocular pressure(IOPs)before treatment was(45.00±3.60)mmHg.Mean intraocular pressure after treatment was(12.00±2.21),(15.20±1.79),(16.52±1.35),(17.28±3.17),(19.00±2.31)mmHg in 1week and 1,3,6,12 months.The IOPs at every follow-up time was significantly different from that before treatment(P<0.05).ConclusionCombining Ahmed glaucoma valve(AGV)implantation with retinal laser photocoagulation after intravitreal anti-VEGF injection may achieve great effect on patients with NVG.