玻璃体腔注射康柏西普联合复合式小梁切除术治疗新生血管性青光眼临床观察

Clinical observation of intravitreous injection of Conbercept combined with complex trabeculectomy in the treatment for neovascular glaucoma

目的观察玻璃体腔注射康柏西普(Conbercept)联合复合式小梁切除术治疗新生血管性青光眼(NVG)的临床疗效。方法选取2014年1~12月在徐州医学院附属淮安医院眼科病区住院并确诊为NVG的22例(22眼)患者,行玻璃体腔注射康柏西普(0.50 mg/0.05 ml),8~14 d后行复合式小梁切除术。观察玻璃体腔注射康柏西普后虹膜新生血管消退的时间,眼压的变化以及复合式小梁切除术后视力和眼压的变化。术后随访3~15个月。结果玻璃体腔注射康柏西普后,17只眼虹膜新生血管1周内完全消退,5只眼2周内完全消退。注药前平均眼压(41.53±3.37)mm Hg,注药后1周平均眼压(40.12±2.13)mm Hg,与注药前比较眼压变化差异无统计学意义(P>0.05)。复合式小梁切除术后1周眼压(11.43±1.68)mm Hg,术后1个月眼压(12.15±1.46)mm Hg,术后3个月眼压(12.81±1.56)mm Hg,最后一次随访眼压(12.03±2.31)mm Hg,与术前比较差异均有统计学意义(P<0.05)。术后最佳矫正视力>0.1者4眼,视力0.01~0.1者15眼,与术前视力比较,差异有统计学意义(P<0.05)。结论玻璃体腔注射康柏西普联合复合式小梁切除术能有效地控制眼压,保护视功能。

Objective To observe the effect of intravitreous injection of Conbercept combined with complex trabeculectomy on neovascular glaucoma(NVG). Methods Twenty-two eyes of 22 patients with NVG in our hospital were treated with intravitreous injection of Conbercept(0.50 mg/0.05 ml) and then complex trabeculectomy 8~14 days later. The regression of iris neovascularization and changes in intraocular pressure(IOP) were observed after injection.Best corrected visual acuity and changes in IOP were observed after complex trabeculectomy. Patients were followed-up for 3~15 months after operation. Results After injection of Conbercept, iris neovascularization completely regressed within 1 week in 17 eyes and within 2 weeks in 5 eyes. The average IOP was(41.53±3.37) mm Hg before injection and(40.12±2.13) mm Hg in a week after injection, showing no statistically significant difference(P>0.05). The IOP at 1 week,1 month, 3 months after complex trabeculectomy were(11.43±1.68) mm Hg,(12.15±1.46) mm Hg,(12.81±1.56) mm Hg,and(12.03±2.31) mm Hg in the last follow-up visit, showing statistically significant difference compared with those before trabeculectomy(P<0.05). After surgery, the best-corrected visual acuity was >0.1 in 4 eyes, 0.01~0.1 in 15 eyes,which showed statistically significant difference with the visual acuity before surgery(P<0.05). Conclusion Intravitreous injection of Conbercept combined with complex trabeculectomy can effectively control the IOP and preserve the visual function in patients with neovascular glaucoma.