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引用:苏锐锋,苏畅,赵敏,谭小波.雷珠单抗辅助玻璃体切割和PRP联合小梁切除术治疗NVG的疗效.国际眼科杂志 2020;20(8):1431-1434,doi:10.3980/j.issn.1672-5123.2020.8.29
雷珠单抗辅助玻璃体切割和PRP联合小梁切除术治疗NVG的疗效
Clinical observation on the treatment of neovascular glaucoma with intravitreal Ranibizumab injection combined with vitrectomy, panretinal photocoagulation and trabeculectomy
投稿时间:2019-12-20  修订日期:2020-07-01
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DOI:10.3980/j.issn.1672-5123.2020.8.29
关键词:  新生血管性青光眼  雷珠单抗  玻璃体切割术  全视网膜光凝术  小梁切除术
Key Words:  neovascular glaucoma  ranibizumab  vitrectomy  panretinal photocoagulation  trabeculectomy
基金项目:河北省自然科学基金项目(No.H2015406054)
Fund Project:Natural Science Foundation of Hebei Province(No.H2015406054)
           
作者单位
苏锐锋 中国河北省承德市,承德医学院附属医院眼科
苏畅 中国河北省承德市,承德医学院附属医院眼科
赵敏 中国河北省承德市,承德医学院附属医院眼科
谭小波 中国河北省承德市,承德医学院附属医院眼科
           
AuthorInstitution
Rui-Feng Su Department of Ophthalmology, the Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Chang Su Department of Ophthalmology, the Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Min Zhao Department of Ophthalmology, the Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Xiao-Bo Tan Department of Ophthalmology, the Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
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目的:观察雷珠单抗辅助玻璃体切割+全视网膜光凝(PRP)+小梁切除术治疗新生血管性青光眼(NVG)的临床疗效。

     方法:回顾性分析2017-03/2018-10收治的NVG患者44例44眼,采用玻璃体腔内注射雷珠单抗+玻璃体切割+PRP+小梁切除手术治疗的患者22例22眼(A组),采用玻璃体腔内注射雷珠单抗+小梁切除+PRP治疗的患者22例22眼(B组)。术后随访6mo,观察患者视力、眼压、眼压控制率、新生血管及并发症等情况。

     结果:治疗前两组患者眼压无差异(46.2±9.41mmHg vs 49.1±10.15mmHg,P>0.05),治疗后1wk,1、6mo A组患者眼压均低于B组(P<0.05)。治疗后6mo,A组视力、眼压控制率(95%)、新生血管消退情况(91%)均优于B组(P<0.05),但随访期间两组患者并发症发生率无差异(P>0.05)。

     结论:雷珠单抗辅助玻璃体切割+PRP+小梁切除术治疗NVG安全有效,可稳定持久地控制眼压,改善部分患者视力。

Abstract:
      AIM: To observe the clinical effect of ranibizumab injection combined with vitrectomy,panretinal photocoagulation(PRP)and trabeculectomy in the treatment of neovascular glaucoma(NVG).

     METHODS: Retrospective study. From March 2017 to October 2018, 44 NVG patients(44 eyes)were treated, 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + vitrectomy + PRP+trabeculectomy(group A), and 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + trabeculectomy+PRP(group B).The patients were followed up for 6mo, the visual acuity, intraocular pressure(IOP), IOP control rate, neovascularization and complications were observed.

     RESULTS: There was no significant difference in IOP between the two groups before treatment(46.2±9.41mmHg vs 49.1±10.15mmHg, P>0.05). The IOP of group A was lower than that of group B at 1wk, 1mo and 6mo after treatment(P<0.05). 6mo after treatment, the visual acuity, IOP control rate(95%)and neovascularization regression(91%)in group A were better than those in group B(P<0.05), but there was no difference in the incidence of complications between the two groups during the follow-up period(P>0.05).

     CONCLUSION: It is safe and effective to treat NVG with intravitreal ranibizumab injection combined with vitrectomy, PRP and trabeculectomy, which can control IOP steadily and improve visual acuity of some patients.

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