雷珠单抗联合小梁切除术治疗新生血管性青光眼

Treatment for neovascular glaucoma with Ranibizumab and trabeculectomy

目的:探讨玻璃体腔内注射雷珠单抗联合小梁切除术治疗新生血管性青光眼(NVG)的疗效。方法:收集2015-09/2017-04我院收治的NVG患者52例52眼的临床资料行回顾性分析,根据手术方式分为A组(玻璃体腔内注射雷珠单抗联合小梁切除术,31眼)和B组(玻璃体腔内注射雷珠单抗联合Ahmed青光眼阀植入术,21眼)。术后随访6mo,比较两组患者手术前后眼压和术后视力、视野、并发症情况,并评定临床疗效。结果:两组患者术后眼压均逐渐降低,术后7d,1、3mo时A组患者眼压均低于B组(P<0.05)。术后6mo,两组患者视力和视野改变情况无明显差异(P>0.05),但A组患者治疗总有效率显著高于B组(97%vs 71%,P=0.013)。随访期间,A组患者角膜水肿、前房积血发生率均低于B组(均P<0.05)。结论:玻璃体腔注射雷珠单抗联合小梁切除术治疗NVG,能有效降低并维持眼压水平,减少术后并发症,疗效显著。

AIM:To investigate the curative effect of intravitreal injection of ranibizumab combined with trabeculectomy on neovascular glaucoma(NVG).METHODS:The clinical data of 52 patients(52 affected eyes)with NVG who were admitted to the hospital between September 2015 and April 2017 were collected and retrospectively analyzed.The patients were divided into group A(intravitreal injection of ranibizumab combined with trabeculectomy,31 affected eyes)and group B(intravitreal injection of ranibizumab combined with Ahmed glaucoma valve implantation,21 affected eyes)according to the surgical method.They were followed up for 6mo after surgery.The intraocular pressure before surgery and after surgery,eyesight,visual field and complications after surgery were compared between two groups.The clinical curative effect was assessed.RESULTS:The intraocular pressure of both groups decreased gradually after surgery.The intraocular pressure of group A was lower than that of group B at 7d,1mo and 3mo after surgery(P<0.05).There was no significant difference in the improvement of eyesight between the two groups at 6mo after surgery(P>0.05).The total effective rate of treatment in group A at 6mo after surgery was obviously higher than that in group B(97%vs 71%,P=0.013).The incidence rates of corneal edema and hyphema in group A were lower than those in group B(P<0.05).CONCLUSION:Intravitreal injection of ranibizumab combined with trabeculectomy for treating NVG can effectively decrease and maintain intraocular pressure and reduce the incidence of postoperative complications,with marked curative effect.