新生血管性青光眼不同治疗方法疗效对比分析
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Compared analysis of the efficacy of different treatment methods for neovascular glaucoma
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    摘要:

    目的:对比三种不同方法治疗新生血管性青光眼(neovasular glaucoma, NVG)的疗效。 方法:对51例54眼NVG患者进行回顾性观察和分析,根据患者的不同手术方式及治疗方法分为3组。A组 27例28眼,行单纯睫状体光凝术;B组 14例14眼,avastin玻璃体腔内注射1wk后行小梁切除术联合丝裂霉素C(MMC)术中敷贴;C组 10例12眼,avastin玻璃体腔内注射1wk后行玻璃体切割术+引流阀植入术。B,C两组均在治疗过程中尽早完成全视网膜光凝术(panretinal photocoagulation, PRP)。 结果:患者出院时平均眼压:A组为25.75±1.44mmHg,手术成功率为21%;B组为12.86±1.37mmHg,手术成功率为86%;C组为16.58±1.85mmHg,手术成功率为83%。 结论:三种方法均不同程度降低眼压。但睫状体光凝术在术后1wk内多数患者眼压控制不在正常范围,故有视力眼不宜选择单纯睫状体光凝术。抗血管内皮生长因子(VEGF)类药物联合抗青光眼手术可在1wk内有效控制眼压,对于保存患者视功能明显优于单纯睫状体光凝术。

    Abstract:

    AIM:To compare the efficacy of three different treatment methods for neovascular glaucoma (NVG). METHODS:Totally 51 NVG patients (54 eyes)were retrospectively observed and analyzed, according to the different surgical treatment the patients were divided into three groups.Group A, 27 patients (28 eyes)were treated with simple cyclophotocoagulation; Group B, 14 patients (14 eyes) with trabeculectomy and intraoperative mitomycin C (MMC) application 1 week after avastin intravitreal injection; Group C , 10 patients (12 eyes) with vitrectomy and drainage valve implantation 1 week after avastin intravitreal injection.In the treatment of both Group B and C, the whole course of panretinal photocoagulation (PRP) were completed as early as possible. RESULTS:The mean intraocular pressure(IOP) in patients discharged from hospital:Group A,25.75±1.44mmHg, surgical success rate was 21%;Group B was 12.86±1.37mmHg, surgical success rate was 86%;Group C was 16.58±1.85mmHg, surgical success rate was 83%. CONCLUSION:The three methods can all reduce IOP on different levels. But IOP in most patients within a week after cyclophotocoagulation is not in the normal range. Therefore, visualizable eye should not choose the simple cyclophotocoagulation.Anti-vascular endothelial growth factor (VEGF) drugs combined with anti-glaucoma surgery can effectively control the IOP within a week.For the preservation of visual function in patients,it was better than simple cyclophotocoagulation.

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杨智,王昕华,李若溪.新生血管性青光眼不同治疗方法疗效对比分析.国际眼科杂志, 2012,12(1):104-106.

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  • 收稿日期:2011-09-21
  • 最后修改日期:2011-11-30
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