玻璃体腔联合前房注射康柏西普对新生血管性青光眼的辅助治疗作用

Auxiliary curative effects of vitreous cavity combined with intracameral injection of conbercept in neovascular glaucoma

目的分析玻璃体腔联合前房注射康柏西普对新生血管性青光眼的辅助治疗效果。方法收集2017年8月至2018年8月于该院行玻璃体腔联合前房注射康柏西普辅助治疗新生血管性青光眼12例(12眼)患者的临床资料。患者均行玻璃体腔联合前房注射康柏西普,待房角及虹膜新生血管消退后2~7 d行复合式小梁切除术或复合式小梁切除术联合白内障超声乳化摘除术,2周后择期行全视网膜光凝术(PRP)。患者随访时间为复合式小梁切除术后1周、1个月、3个月、6个月。观察注药后血管消退情况、术后最佳矫正视力、眼压、屈光介质混浊程度、术后并发症及能否行PRP。结果玻璃体腔联合前房注射康柏西普后2~7 d 12眼虹膜及房角血管消退,可行复合式小梁切除术。与术前比较,术后1周、1个月、3个月、6个月眼压均下降(P<0.05)。术后2眼(16.67%)最佳矫正视力提高,10眼(83.33%)视力无明显变化,无视力下降。复合式小梁切除术或复合式小梁切除术联合白内障超声乳化摘除术后1周,11眼(91.70%)屈光介质恢复透明。术后并发症主要为前房积血。复合式小梁切除术后2周,11眼(91.70%)能行PRP。结论玻璃体腔联合前房注射康柏西普对新生血管性青光眼有良好的辅助治疗效果,为后续开展PRP创造了的条件。

Objective To analyze the auxiliary treatment effect of vitreous cavity combined with intracameral injection of conbercept in neovascular glaucoma(NVG).Methods The clinical data in 12 cases of NVG(12 eyes)treated by vitreous cavity combined with intracameral injection of conbercept in this hospital from August 2017 to August 2018 were collected.All patients underwent the therapy of vitreous cavity combined with intracameral injection of conbercept.On 2-7 d after the neovascularization of anterior chamber and iris disappearance,the complex trabeculectomy or complex trabeculectomy combined with cataract phacoemulsification was performed.After 2 weeks,panretinal photocoagulation(PRP)was electively performed.All cases were followed up for 1 week,1 month,3 months and 6 months after complex trabeculectomy.The neovascularization degradation situation,postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),opacity of refractive medium,postoperative complications were observed and whether further PRP could be performed.Results On 2-7 d after vitreous cavity combined with intracameral injection of conbercept,the vessels of iris and the anterior chamber regressed faded away.The complex trabeculectomys could be performed.Compared with before operation,postoperative IOP on postoperative 1 week,1 month,3 months and 6 months was decreased(P<0.05).BCVA in postoperative 2 eyes(16.67%)was increased,which in 10 eyes(83.33%)had no obvious change,no case of visual acuity decrease occurred.The refracting media in 11 eyes(91.70%)recovered to transparency at 1 week after complex trabeculectomy or complex trabeculectomy combined with cataract phacoemulsification.The postoperative complications were mainly anterior chamber hemorrhage.On 2 weeks after complex trabeculectomy,11 eyes(91.70%)could perform PRP.Conclusion The vitreous cavity combined with intracameral injection of conbercept has good auxiliary curative effect for NVG and creates a favorable conditions for subsequent PRP.