摘要
目的探讨复合小梁切除术联合视网膜光凝术及玻璃体腔注射雷珠单抗治疗新生血管性青光眼的疗效。方法回顾性分析视网膜中央静脉阻塞病变继发新生血管性青光眼,能看清眼底进行视网膜激光光凝术的患者8例(8眼),首先给予视网膜光凝术,继之给以玻璃体腔雷珠单抗注射,1周后行复合小梁切除术,术后根据患者眼压及前房情况给予眼球按摩,并教会患者出院后自己按摩眼球,记录术前及术后3、6、12个月患者视力、眼压、虹膜及房角新生血管变化、OCT黄斑厚度检查、眼底视网膜新生血管消退及无灌注区变化情况。结果视力:3个月:(0.04±0.04),6个月:(0.06±0.05),12个月:(0.05±0.04),视力提高4眼,3眼无明显提高,1眼为无光感眼。眼压:3个月:(13.24±2.23)mmHg,6个月:(15.4±23.42)mmHg,12个月:(18.25±3.15)mmHg,6例患者眼压均控制在21 mmHg以下;1例患者前3个月眼球按摩后眼压控制尚可,逐渐升高至21 mmHg后,局部滴用阿法根眼水3次/d,眼压可以控制在18 mmHg左右,6个月后眼压升至19 mmHg左右,9个月眼压又升至21 mmHg,加点派立明眼水每日3次,眼压控制在20 mmHg左右,12个月复查22 mmHg,此患期间补充两次视网膜光凝,虹膜面少量新生血管残留,滤过泡略扁平,其中1例前6个月眼压一直低于16 mmHg,但呈上升趋势,10个月时眼压到20 mmHg,11个月21 mmHg时滴用阿法根眼水3次/d控制18 mmHg左右,12个月复查时眼压19 mmHg。新生血管消退情况:虹膜及房角新生血管5例消退。3例明显减少,荧光血管造影显示眼底5例毛细血管无灌注区消失,新生血管消退,3例于补充视网膜激光光凝后毛细血管新生血管消退,无灌注区消失。黄斑中心凹厚度(CMT)的改变:治疗前、玻璃体腔注药术后1、2、4、8、12周CMT值分别为(440.36±50.56)μm、(376.06±28.60)μm、(365.45±30.02)μm、(361.38±29.56)μm、(358.68±30.46)μm、(360.43±29.36)μm。结论复合小梁切除术联合全视�
Objective To comparatively evaluate the efficacy and safety profiles of compound trabeculectomy and Retinal photocoagulation and Vitreous injection Ranibizumab in the management of New vascular glaucoma.Method Clinical records of 8 patients（8 eyes）with New vascular glaucoma secondary to RVO whose fundus oculi can be watched to be treated with Retinal laser photocoagulation first the pathants were threated with Retinal laser photocoagulation,the second were Vitreous injection Ranibizumab seven days with compound trabeculectomy after surgery,according to patients iop and Anterior chamber to teach patients to learning Eye massage？Record visions,central macular thickness（CMT）,intraocular pressure（IOP）,the degrade of Retinal neovascularization of fundus oculi and new vessels changes of iris and angles in Preoperative and postoperative 3 months,6 months,12 months.Result The Vision：3 months：（0.04±0.04）,6 months：（0.06±0.05）,12 months：（0.05±0.04）,4 eye＇s Vision were improved 3 eye＇s Vision werenot improved.The one eye is No light perception.IOP：3 months：（13.24±2.23）mmhg,6 months：（15.4±23.42）mmhg,12 months：（18.25±3.15）mmhg,6 patients can controled IOP under 21 mmhg,postoperative one patient iop can be controled in normal in first 3 months,give Alphagan eye water in rising to 21 mmhg of iop,iop can be control in 18 mmhg,6 months later the iop rise to 19 mmhg,in 9 months the iop rised to 21 mmhg,Brinzolamide eye water was used,iop can be control in 20 mmhg,in 12 months,iop is 22 mmhg,22 mmhg,in Process,the patient Supplement Retinal photocoagulation twice new vessels changes of iris and angles：5 cases degrade,3 cases Reduce,FFA：Capillary zone degrade of 5 cases;Capillary zone degrade of 3 cases in Supplement Retinal laser photocoagulation,CMT：Before treatment and1 week,2weeks,4weeks,8weeks,12 weeks after Vitreous cavity injection was：（440.36±50.56）μm.（376.06± 28.60）μm.（365.45±30.02）μm.（361.38±29.56）μm.（358.68±30.46）μm.（360
出处
《内蒙古医学杂志》
2015年第10期1186-1188,共3页
Inner Mongolia Medical Journal
