雷珠单抗与康柏西普治疗白内障术后黄斑水肿的临床效果观察

Clinical Effect of Leizumab and Compaximab in the Treatment of Macular Edema after Cataract Operation

目的:观察比较雷珠单抗与康柏西普治疗白内障术后黄斑水肿(Pseudophakic cystoid macular edema,PCEM)临床效果及安全性。方法:选取我院2021年5月至2023年3月收治的89例PCEM患者,根据治疗方案将其分为对照组、观察组。对照组44例采用康柏西普治疗,观察组45例采用雷珠单抗治疗。比较两组临床疗效、角膜神经纤维密度和长度、视力(BCVA)、眼压、黄斑厚度(CMT)、房水因子指标[白介素-6(IL-6)、IL-37、血管内皮生长因子(VEGF)]及术后不良反应。结果:观察组治疗总有效率88.89%与对照组93.18%比较,无显著差异(P>0.05);注射1、2、3次后两组BCVA、眼压、CMT注射前比较均明显改善(P<0.05),两组间比较,BCVA、眼压、CMT无显著差异(P>0.05);注药1、2、3次后两组CNFD与注药前比较无显著差异(P>0.05),观察组CNFL与注药前比较无显著差异(P>0.05),对照组CNFL与注药前、观察组明显降低(P<0.05);注药3次后,两组IL-6、IL-37、VEGF较治疗前均降低(P<0.05),两组间比较,IL-6、IL-37、VEGF无显著差异(P>0.05);观察组不良反应发生率6.67%与对照组4.55%比较无显著差异(P>0.05)。结论:雷珠单抗与康柏西普治疗PCEM的疗效相当,且安全性较好,但前者对角膜神经具有一定影响。

Objective:To observe and compare the clinical efficacy and safety of Leizumab and Comcaercep in the treatment of Pseudophakic cystoid macular edema(PCEM)after cataract surgery.Methods:Eighty-nine patients with PCEM admitted to our hospital from May 2021 to March 2023 were selected and divided into control group and observation group according to the treatment plan.The control group(44 cases)was treated with Compaplomp,and the observation group(45 cases)was treated with leizumab.The clinical efficacy,corneal nerve fiber density and length,visual acuity(BCVA),intraocular pressure,macular thickness(CMT),aqueous humor factors[interleukin-6(IL-6),IL-37,vascular endothelial growth factor(VEGF)]and postoperative adverse reactions were compared between the two groups.Results:The total treatment efficiency of observation group was 88.89%compared with control group 93.18%,there was no significant difference(P>0.05).After 1,2 and 3 injections,BCVA,IOP and CMT before injection were significantly improved(P<0.05),but there were no significant differences in BCVA,IOP and CMT between the two groups(P>0.05).There was no significant difference in CNFD between the two groups after 1 infusion,2 infusion and 3 infusion(P>0.05),there was no significant difference in CNFL between the observation group and before infusion(P>0.05),and CNFL was significantly decreased between the control group and before infusion and observation group(P<0.05).After 3 times of injection,IL-6,IL-37 and VEGF were decreased in 2 groups compared with before treatment(P<0.05),and there were no significant differences in IL-6,IL-37 and VEGF between 2 groups(P>0.05).The incidence of adverse reactions in the observation group was 6.67%compared with 4.55%in the control group(P>0.05).Conclusion:The efficacy and safety of lezumab in the treatment of PCEM are comparable to that of Compaucept,but the former has a certain effect on corneal nerves.