引流阀植入及雷珠单抗治疗新生血管性青光眼

Ahmed valve implantation and ranibizumab for the treatment of neovascular glaucoma

目的评价Ahmed引流阀植入及前房注射雷珠单抗治疗新生血管性青光眼的效果。方法对2014年6月至2016年6月潍坊市益都中心医院治疗的新生血管性青光眼35例(35眼)的临床资料进行回顾性分析。患者随机分为两组,A组,19例,前房注射雷珠单抗后进行Ahmed阀植入术;对照组,16例,进行单纯Ahmed阀植入术。随访6个月比较两组的效果。结果术后A组和B组手术成功率分别为78.95%和75.00%,两组相比差异无统计学意义(χ^2=0.08,P=0.55),术后1周、1个月、3个月及6个月两组眼压比较(t=1.68、1.38、0.14、0.26,P=0.102、0.177、0.989、0.98),术后两组视力比较,差异均无统计学意义(t=-0.290,P=0.630)。A组手术时间短于B组(t=8.924,P=0.000);A组并发症少于B组,差异均有统计学意义(χ^2=8.69,P=0.03)。结论两种手术方式同样有效控制眼压,提高视力,但前房注射雷珠单抗后植入Ahmed引流阀能缩短手术时间、减少并发症。

Objective To evaluate the efficacy of Ahmed glaucoma valve implantation and ranibizumab in the treatment of neovascular glaucoma. Methods The data of 35 eyes of 35 cases of neovascular glaucoma from Jun. 2014 to Jun. 2016 in Yidu Central Hospital were analyzed retrospectively. They were randomly divided into two groups, group A, 19 eyes received Ahmed valve implantation after anterior chamber injection of ranibizumab and group B, 16 eyes only received Ahmed valve implantation. The follow-up time was 6 months. Results The surgical success rate of group A was 78.95% and 75.00% of group B, the difference was not statistically significant (χ^2=0.08, P=0.55). The difference of intraocular pressure at 1 week, 1, 3 and 6 months, postoperatively (t=1.68、1.38、0.14、0.26, P=0.102、0.177、0.989、0.98) were not statistically significant. Postoperative visual acuity of two groups improved, the difference was not statistically significant (t=-0.290, P=0.630). The difference of operative time was statistically significant between the two groups (t=8.924, P=0.000). Complications in group A was less than that in group B (χ^2=8.67, P=0.26). Conclusion Two kinds of operation method can effectively control the IOP and improve visual acuity, but Ahmed valve implantation and anterior chamber injection of ranibizumab can quickly and effectively resolve iris neovascularization, effectively shorten the operation time.