摘要
目的探讨玻璃体腔内注射雷珠单抗分别联合不同青光眼手术的疗效及安全性。方法前瞻性选取2015年7月至2017年6月就诊的NVG患者74例(74眼)。随机分为引流阀植入组与小梁切除组,采用玻璃体腔注射雷珠单抗分别联合Ahmed青光眼引流阀植入术与小梁切除术,共随访半年,对比观察两组患者在使用雷珠单抗7 d后虹膜新生血管的状况,以及治疗前后眼压、视力以及并发症。结果两组患者均成功完成手术。两组患者在玻璃体内注射雷珠单抗7 d后,虹膜新生血管消退率100%。两组眼压:术后7 d开始至术后6个月眼压均较注射前明显降低(P<0.05)。两组眼压比较,术后3个月及6个月引流阀植入组眼压均低于小梁切除组,差异显著(P<0.05)。术后6个月两组视力提高差异无统计学意义(P>0.05)。两组视力平均值:术后3个月及6个月引流阀植入组均高于小梁切除组,差异具有显著性(P<0.05)。两组并发症发生率差异无显著性(P>0.05)。结论玻璃体腔注射雷珠单抗联合青光眼手术均取得较好的疗效,且无明显并发症。玻璃体腔注射雷珠单抗分别联合Ahmed青光眼引流阀植入术较联合小梁切除术更能降低患者眼压及改善视力,且更为持久。
Objective To investigate the efficacy and safety of glass body cavity injection of ranibizumab combined with anti-glaucoma surgery on NVG.Methods From July 2015 to June 2017,74 cases(74 eyes)of NVG patients were selected,who were randomly divided into drainage group and trabecular resection group.The glass body cavity injection of ranibizumab respectively combined with drainage of Ahmed glaucoma valve implantation and trabeculectomy were performed and the patients were followed up for half a year.The iris neovascularization after 7 d and intraocular pressure,vision and complications before and after the treatment were compared.Results Two groups of patients were successfully completed surgery.The iris neovascularization fading rate after 7 d in two groups was 100%.Intraocular pressure:7 d to 6 months after surgery,intraocular pressure was lower before the injection(P<0.05).Intraocular pressure,3 months to 6 months after drainage valves implanted intraocular pressure was lower than trabecular resection group with significant difference(P<0.05).Six months after treatment,eyesight was improved similarly between the two groups without statistical significance(P>0.05).Average vision:3 months and 6 months after treatment,drainage of glaucoma valve implantation was higher than trabeculectomy with significant difference(P<0.05).The incidence of complications in the two groups had no significant difference(P>0.05).Conclusion Glass body cavity injection with ranibizumab combined with glaucoma surgery has good curative effect,and no obvious complications.Glass body cavity injection with ranibizumab combined with drainage of Ahmed glaucoma valve implantation,compared with trabeculectomy,can well reduce pressure and improve the vision,and more enduring.
作者
王玲
刘伟仙
黄雄高
WANG Ling;LIU Wei-xian;HUANG Xiong-gao(Department of Ophthalmology,The First Affiliated Hospital of Hainan Medical College,Haikou Hainan 570102,China)
出处
《临床和实验医学杂志》
2018年第6期627-630,共4页
Journal of Clinical and Experimental Medicine
