抗VEGF联合Ahmed引流阀治疗NVG术中是否联合超乳的对比观察
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Clinical effects of anti-VEGF combined with Ahmed valve implantation and phacoemulsification or not for neovascular glaucoma with cataract
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    摘要:

    目的:观察抗VEGF联合Ahmed引流阀植入术中白内障超声乳化与非超乳治疗合并白内障的新生血管性青光眼(NVG)的疗效。

    方法:回顾分析我院诊断为NVG合并白内障的患者47例47眼,术前均行抗VEGF玻璃体积内注射,其中19眼行白内障超声乳化吸除术联合Ahmed引流阀植入术(联合组),28眼行单纯Ahmed引流阀植入术(单阀组),术后观察视力、眼压和用药情况,并随访6mo以上。

    结果:NVG患者47眼中,术后各时间点眼压均较术前显著降低(P<0.05)。随访至6mo时,联合组患者视力提高者10 眼(53%),不变者8眼(42%),降低者1眼(5%); 手术完全成功率为84%(16/19),条件成功率 11%(2/19),失败5%(1/19); 单阀组患者视力提高者11眼(39%),不变者17眼(61%),降低者0例,手术完全成功率为61%(17/28),条件成功率 25%(7/28),失败14%(4/28)。

    结论:抗VEGF和单纯Ahmed引流阀植入术联合白内障超声乳化摘除手术既能有效控制术后眼压,又尽可能提高患者视力,减少术后青光眼药物使用量,便于随诊眼底,是治疗NVG的有效方法。

    Abstract:

    AIM:To compare the efficacy of anti-VEGF combined with Ahmed valve implantation with phacoemulsification or not for neovascular glaucoma(NVG)with cataract.

    METHODS: Totally 47 patients(47 eyes)of NVG with cataract were given intraocular injection of anti-VEGF before the surgery, and then treated with Ahmed valve implantation. 19 cases(19 eyes)combined with phacoemulsification, and single Ahmed valve implantation in 28 cases(28 eyes). The vision, IOP, anti-glaucoma medicines and complications of the two groups were recorded and compared with 6mo postoperatively.

    RESULTS:The IOP of all cases at all time points after surgery was significantly decreased after surgery(P <0.05). 6mo after surgery, in the combined group, the vision was improved in 10 cases(10 eyes)(53%), unchanged in 8 cases(8 eyes)(42%)and decreased in 1 case(1 eye)(5%). The complete success rate was 84%(16/19), the conditional success rate was 11%(2/19), and the failure rate was 5%(1/19). In the single Ahmed valve group, the vision was improved in 11 cases(11 eyes)(39%), unchanged in 17 cases(17 eyes)(61%), decreased in 0 case(0 eye)(0%), complete success rate in operation was 61%(17/28), conditional success rate was 25%(7/28), and the failure rate was 14%(4/28).

    CONCLUSION: Compare with anti-VEGF with Ahmed vlave implantation, combined with phacoemulsification can effectively control the postoperative IOP, improve the BCVA of the patient as much as possible, reduce the amount of the postoperative glaucoma medicament use, and facilitate the follow-up of the fundus of the patient. It is a efficacy treatment for NVG with cataract.

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赵丽君,王亚辰,张立军.抗VEGF联合Ahmed引流阀治疗NVG术中是否联合超乳的对比观察.国际眼科杂志, 2019,19(8):1348-1351.

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  • 收稿日期:2019-04-07
  • 最后修改日期:2019-07-15
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  • 在线发布日期: 2019-07-25
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