目的：观察新型EX-PRESS青光眼引流器植入术联合雷珠单抗治疗新生血管性青光眼(NVG)的临床疗效及安全性。

方法：选择2015-06/2018-06在我院确诊为NVG且行玻璃体腔注射雷珠单抗的患者78例78眼，将其中随访资料完整者60例60眼根据治疗方式不同分为试验组30例30眼，行EX-PRESS 青光眼引流器植入术。对照组30例30眼行常规小梁切除术。观察术后1wk，1、3、6mo及1a BCVA、眼压，术后早期并发症，于术后6mo，1a评估手术成功率。

结果：术后1wk，1、3mo，试验组BCVA<0.1者25眼、25眼和23眼，平均眼压为16.76±3.21、15.63±2.70及16.69±3.29mmHg，对照组为26眼、26眼和25眼，平均眼压为17.31±2.96、14.44±2.53及16.56±4.14mmHg(均P>0.05)； 术后6mo，1a试验组BCVA<0.1者为16眼和16眼，平均眼压为15.49±3.19、18.52±4.03mmHg，对照组为25眼和25眼，平均眼压分别为21.96±2.90、28.90±4.33mmHg(均P<0.05)； 试验组术后低眼压、浅前房、前房出血、炎症反应、脉络膜脱离的发生例数分别为0眼、1眼、2眼、1眼、0眼，而对照组分别为6眼、6眼、5眼、4眼、2眼； 试验组术后6mo，1a手术成功率为83%及80%，而对照组分别为60%及53%(P<0.05)。

结论：EX-PRESS青光眼引流器植入术联合玻璃体腔注射雷珠单抗治疗NVG能够有效地降低患者的眼压，且具有手术切口小、操作简单、安全、术后并发症少、手术成功率高等优点。

METHODS: A total of 78 patients(78 eyes)who were diagnosed with neovascular glaucoma and underwent intravitreal injection of ranibizumab drugs in our hospital from June 2015 to June 2018 were selected. Sixty patients with complete follow-up data were randomly divided in the experimental group(A), 30 patients(30 eyes)underwent EX-PRESS glaucoma drainage device implantation. Postoperative complications were observed early, visual acuity and intraocular pressure were observed at 1wk, 1mo, 3mo, 6mo and 1a, and the success rate of the operation was evaluated at 6mo and 1a.

RESULTS:After 1wk, 1, 3mo, 25 eyes, 25 eyes and 23 eyes with BCVA <0.1 in the experimental group, the average intraocular pressure was 16.76±3.21mmHg, 15.63±2.70mmHg and 16.69±3.29mmHg, the control group was 26 eyes, 26 eyes and 25 eyes, the average IOP was 17.31±2.96mmHg, 14.44±2.53mmHg and 16.56±4.14mmHg(all P>0.05); 6mo after operation, 16 eyes and 16 eyes in the 1a test group with BCVA <0.1 were the average IOP 15.49±3.19mmHg, 18.52±4.03mmHg, the control group was 25 eyes and 25 eyes, the average intraocular pressure was 21.96±2.90mmHg, 28.90±4.33mmHg(all P<0.05); the experimental group had low intraocular pressure, shallow The number of cases of anterior chamber, anterior chamber hemorrhage, inflammation, choroidal detachment were 0 eyes, 1 eyes, 2 eyes, 1 eyes, 0 eyes, while the control group were 6 eyes, 6 eyes, 5 eyes, 4 eyes, 2 eyes(P<0.05); 6mo after operation in the experimental group, the success rate of 1a operation was 83% and 80%, while that in the control group was 60% and 53%, respectively(P<0.05).

CONCLUSION: EX-PRESS glaucoma drainage implantation combined with ranibizumab drug treatment in the vitreous cavity can effectively reduce the intraocular pressure in patients with neovascular glaucoma and has the advantages of small surgical incision, simple operation, safety, fewer postoperative complications, and high success rate of surgery.