玻璃体腔内注射雷珠单抗辅助治疗伴玻璃体积血的新生血管性青光眼的效果

Follow-up study of intravitreous injection of leizumab combined with compound trabeculectomy for treatment of neovascular glaucoma with vitreous hematocele

目的:探讨玻璃体腔内注射雷珠单抗辅助治疗伴玻璃体积血的新生血管性青光眼的效果。方法:选取2018年1月—2020年8月某院伴玻璃体积血的新生血管性青光眼患者98例,根据治疗方案不同分为观察组(51例)和对照组(47例)。对照组采用复合式小梁切除术,观察组采用玻璃体腔内注射雷珠单抗联合复合式小梁切除术,对比2组治疗效果、并发症发生率,随访3个月,对比2组不同时间眼压水平、最佳矫正视力及滤过泡眼数。结果:观察组总有效率为94.12%,高于对照组的78.72%(P<0.05);随访3个月,2组均无脱落病例,有效随访98例,术后1周、术后1个月眼压逐渐降低,术后3个月眼压升高,观察组低于对照组(P<0.05);术后1个月、术后3个月最佳矫正视力改善,观察组优于对照组(P<0.05);术后1个月、术后3个月观察组功能性滤过泡眼数和术后3个月非功能性滤过泡眼数高于对照组(P<0.05);2组并发症发生率比较,差异无统计学意义(P>0.05)。结论:玻璃体腔内注射雷珠单抗联合复合式小梁切除术治疗伴玻璃体积血的新生血管性青光眼效果显著,能有效控制眼压,保护视功能且并发症少。

Objective:To investigate the effect of intravitreous injection of leizumab combined with compound trabeculectomy in treatment of neovascular glaucoma with vitreous hematocele.Methods:A total of 98 patients with neovascular glaucoma with vitreous hematocele in a hospital from January 2018 to August 2020 were selected and divided into an observation group(51 cases)and a control group(47 cases)according to different treatment regimens.The control group underwent compound trabeculectomy while the observation group was treated with intravitreous injection of leizumab combined with compound trabeculectomy.The treatment effect and incidence of complications were compared between the two groups.A 3-month follow-up was conducted to compare the intraocular pressure(IOP)level at different times,the best corrected visual acuity,and the number of functional and non-functional filter blebs.Results:The total effective rate of the observation group was 94.12%,higher than that of the control group(78.72%),the difference being statistically significant(P<0.05).The patients were followed up for 3 months,and no cases fell out.All the 98 patients were followed up effectively.The IOP declined in both groups one week and one month after the operation.Three months after the operation the IOP in the observation group was lower than that in the control group,the difference being statistically significant(P<0.05).The best corrected visual acuity improved 1 month and 3 months after the surgery,and the observation group was better than the control group,the difference being of statistical significance(P<0.05).The number of functional filtration bubbles 1 month and 3 months after the surgery and the number of non-functional filtration bubbles 3 months after the surgery in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Intravitreous injection of leizumab combined with compound trabeculectomy in the treatment of neovascular glaucoma with vitreous hematocele is effective in controlling IOP and protecting visual function,with few complications and high safety.