小梁切除术联合雷珠单抗治疗新生血管性青光眼的效果观察

Observation of therapeutic effect of trabeculectomy combined with ranibizumab on neovascular glaucoma

目的探讨小梁切除术联合雷珠单抗治疗新生血管性青光眼(NVG)的临床效果。方法队列研究。抽取2022年6月至2023年6月西安市第一医院收治的NVG患者84例,按随机数字表法分为对照组和观察组,每组42例(42只患眼)。对照组给予小梁切除术治疗,观察组在对照组基础上加用雷珠单抗治疗。比较两组治疗效果、眼压、视力水平、眼动脉血流动力学指标[血流阻力系数(RI)、舒张末期血流速度(EDV)、收缩期峰值流速(PSV)]及并发症发生率。结果观察组总有效率(95.24%,40/42)高于对照组(80.95%,34/42),P<0.05。治疗后3个月,观察组眼压[(13.46±1.41)mmHg,1 mmHg=0.133 kPa]低于对照组[(15.73±1.52)mmHg],最佳矫正视力(0.87±0.11)高于对照组(0.73±0.13),P<0.05。治疗后3个月,观察组RI(0.52±0.10)低于对照组(0.67±0.11),EDV[(10.36±0.66)cm/s]、PSV[(35.09±2.11)cm/s]高于对照组[(9.02±0.79)、(31.38±2.24)cm/s],P<0.05。观察组并发症发生率(2.35%,1/42)低于对照组(19.05%,8/42),P<0.05。结论小梁切除术联合雷珠单抗能增强NVG的治疗效果,降低眼压,改善眼动脉血流动力学指标,减少并发症。

Objective To investigate the effect of trabeculectomy combined with ranibizumab on neovascular glaucoma(NVG).Methods A cohort study was adopted in this study.A total of 84 NVG patients admitted to Xi’an First Hospital from June 2022 to June 2023 were selected,and they were divided into a control group and an observation group using a random number table method,with 42 cases(42 affected eyes)in each group.The control group was treated by trabeculectomy,while the observation group was treated with ranibizumab based on the treatment of the control group.The treatment efficacy,intraocular pressure,visual acuity level,ocular artery hemodynamic indicators,including resistance index(RI),end diastolic velocity(EDV)and peak systolic velocity(PSV),and incidence of complications were compared between the two groups.Results The total effective rate of the observation group(95.24%,40/42)was higher than that of the control group(80.95%,34/42),P<0.05.Three months after treatment,the intraocular pressure in the observation group was(13.46±1.41)mmHg(1 mmHg=0.133 kPa),which was lower than the(15.73±1.52)mmHg in the control group,moreover,the best corrected visual acuity in the observation group(0.87±0.11)was higher than that in the control group(0.73±0.13),P<0.05.The RI of the observation group(0.52±0.10)was lower than that of the control group(0.67±0.11)3 months after treatment(P<0.05).Three months after treatment,the EDV and PSV in the observation group were(10.36±0.66)cm/s and(35.09±2.11)cm/s,respectively,which were higher than the(9.02±0.79)cm/s and(31.38±2.24)cm/s in the control group(P<0.05).The incidence of complications in the observation group(2.35%,1/42)was lower than that in the control group(19.05%,8/42),P<0.05.Conclusions Trabeculectomy combined with ranibizumab can improve the therapeutic effect of NVG,reduce intraocular pressure,improve ophthalmic artery hemodynamic indicators and reduce the incidence of complications.