康柏西普联合全视网膜激光光凝治疗CRVO继发新生血管性青光眼

Combined treatment of Conbercept and panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion

目的:探讨康柏西普联合全视网膜激光光凝(panretinal photocoagulation,PRP)治疗视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)继发新生血管性青光眼(neovascular glaucoma,NVG)的疗效。方法:本组观察对象为2014-05/2017-05于我院眼科治疗的CRVO继发NVG患者100例100眼,现回顾性分析其病历资料,将采用青光眼滤过性手术联合PRP治疗的50例患者设为对照组,在此治疗基础上加用玻璃体腔注射康柏西普的50例患者设为观察组。比较术前、术后7d,1、3、6mo最佳矫正视力(best corrected visual acuity,BCVA),并采用非接触式眼压计比较各时期眼压,裂隙灯检查新生血管消退情况并结合眼压等判断手术效果,随访6mo记录术后复发率及并发症发生情况。结果:两组患者术后1、3、6mo BCVA趋于稳定,术后BCVA与术前比较,组间各时间点比较差异无统计学意义(P>0.05);两组术后7d,1、3、6mo眼压均显著低于术前,术后7d,1mo观察组显著低于对照组,差异有统计学意义(P<0.05),术后3、6mo组间比较差异无统计学意义(P>0.05);观察组手术成功率为100%,与对照组(92%)比较差异具有统计学意义(P<0.05),观察组手术完全成功率为84%,显著高于对照组(66%),差异有统计学意义(P<0.05);观察组前房出血及复发率显著低于对照组,差异有统计学意义(P<0.05),两组患者浅前房、低眼压发生率差异无统计学意义(P>0.05)。结论:术前玻璃体腔注射康柏西普联合PRP治疗CRVO继发NVG眼压恢复时间更短,手术效果更优,能控制前房出血并降低复发率。

AIM:To investigate the efficacy of the combined treatment of Conbercept and panretinal photocoagulation(PRP)for neovascular glaucoma(NVG)with central retinal vein occlusion(CRVO).METHODS:The clinical data of 100 NVG patients with CRVO treated in our hospital from May 2014 to May 2017 were retrospectively analyzed.In those,50 patients treated with glaucoma filtering surgery combined with PRP were selected as control group,and based on this,50 patients treated with intravitreal injection of conbercept were included in the observation group.The best corrected visual acuity(BCVA)before treatment,and after 7d,1,3,and 6mo treatment were compared.The intraocular pressure IOP of each period with the non-contact tonometer were also compared,the effect of surgery was evaluated by slit-lamp examination of neovascularization combined with intraocular pressure,and then recurrence rate and complication was recorded during 6mo follow-up.RESULTS:No statistically significant difference was found between preoperative and after surgery at each time point(P>0.05).The intraocular pressure of the two groups was significantly lower than that of before the surgery,the observation group was significantly lower than that of the control group 7d and 1mo after surgery,and the difference was statistically significant(P<0.05).There was no statistically significant difference on IOP the 3 and 6mo after surgery between two groups(P>0.05).The operation success rate was 100%in the observation group and was 92%in the control group,the difference was statistically significant(P<0.05).The complete success rate of the observation group was 84%,which was significantly higher than 66%of the control group,the difference was statistically significant(P<0.05).The hyphema and recurrence rate of the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of shallow anterior chamber and low intraocular pressure(P>0.05).CONCLUSION:Preoperative intravitreal injection of conbercept combined with panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion make the pressure recovery and neovascularization time shorter with better surgical results,and can control the anterior chamber hemorrhage and reduce the recurrence rate.