新生血管性青光眼应用小梁切除术、E-PRP联合玻璃体腔注射康柏西普、虹膜周边切除术效果研究

Study on the Effect of Trabeculectomy,E-PRP Combined with Intravitreal Injection of Conbercept and Peripheral Irisectomy in Neovascular Glaucoma

目的探讨新生血管性青光眼应用小梁切除术、超全视网膜光凝术(E-PRP)联合玻璃体腔注射康柏西普、虹膜周边切除术治疗的效果。方法收集2019年5月至2020年5月该院接收的新生血管性青光眼患者92例,根据随机数字表法将其分为两组,对照组46例予以小梁切除术联合E-PRP治疗,观察组46例应用小梁切除术、E-PRP联合玻璃体腔注射康柏西普、虹膜周边切除术治疗,对比两组临床疗效、视力恢复情况、房水血管内皮生长因子(VEGF)和血小板衍生生长因子(PDGF)水平、眼压、视网膜静脉循环时间及视野缺损值。结果观察组总有效率为96.65%,比对照组(76.09%)高,且观察组视力恢复情况优于对照组(P<0.05);观察组治疗后6个月时房水VEGF、PDGF水平比对照组低(P<0.05);观察组治疗后6个月时的眼压、视网膜静脉循环时间、视野缺损值均比对照组低(P<0.05)。结论新生血管性青光眼应用小梁切除术、E-PRP联合玻璃体腔注射康柏西普、虹膜周边切除术治疗可提升疗效,促进视力恢复,并有效改善房水VEGF、PDGF水平、眼压、视网膜静脉循环时间及视野缺损值。

Objective To discuss the effect of neovascular glaucoma with trabeculectomy,ultra-pan retinal photocoagulation(E-PRP)combined with intravitreal injection of Conbercept and peripheral irisectomy.Methods A total of 92 cases of neovascular glaucoma patients who were received in our hospital from May 2019 to May 2020 were collected,randomly divided into two groups according to the random number table method.46 cases in the control group were treated with trabeculectomy and E-PRP,and 46 cases in the observation group were treated with trabeculectomy,E-PRP combined with intravitreal injection of conbercept,and peripheral iris resection.The clinical effects,visual recovery,aqueous vascular endothelial growth factor(VEGF)and platelet-derived growth factor(PDGF)levels,intraocular pressure,retinal venous circulation time and visual field defect values were compared between the two groups.Results In the observation group,the total effective rate was 96.65%,which was higher than 76.09%of the control group,and in the observation group,the visual recovery of was better than the control group(P<0.05).In the observation group,the levels of VEGF and PDGF in aqueous humor 6 months after treatment were lower than the control group(P<0.05).In the observation group,the intraocular pressure,retinal venous circulation time and visual field defect values of 6 months after treatment were lower than the control group(P<0.05).Conclusion The treatment of neovascular glaucoma with trabeculectomy,E-PRP combined with intravitreal injection of Conbercept,and peripheral iris excision can improve the curative effect,promote the recovery of vision,as well as effectively improve the aqueous VEGF,PDGF levels,and intraocular pressure,retinal vein circulation time and visual field defect value.