摘要
目的:探讨玻璃体腔注射康柏西普后对新生血管性青光眼(NVG)患者房水中VEGF、IL-6、IL-8的影响,并观察其联合不同手术方式对NVG患者的疗效。方法:选择2019-01/2020-02在中国人民解放军新疆军区总医院全军眼科中心就诊的NVG患者102例,均玻璃体腔注射康柏西普,3~5d后行手术治疗,按照随机数字抽签法分为小梁切除术组(50例50眼)及EX-PRESS引流器植入术组(52例52眼),运用酶联免疫吸附法分析房水中VEGF、IL-6、IL-8的变化情况,观察虹膜新生血管消退情况,比较两组手术疗效及术后眼压变化、视力改善情况及并发症发生情况。结果:玻璃体腔注射康柏西普3~5d后房水中VEGF、IL-6、IL-8表达水平较术前降低(均P<0.05);术后随访各时间点两组眼压水平均显著低于术前(均P<0.05),两组患者眼压在术后3、6、12mo组间比较有差异(均P<0.05);术后6、12mo时EX-PRESS组视力优于小梁切除术组(P<0.05);术后12mo,两组使用抗青光眼药物种类及数量无明显差异(均P>0.05);随访12mo,EX-PRESS组患者手术成功率(86.5%)优于小梁切除术组(70.0%),且EX-PRESS组术后并发症发生率显著低于小梁切除术组(P<0.05)。结论:玻璃体腔注射康柏西普后可以降低NVG患者房水中VEGF、IL-6、IL-8等因子表达,同时小梁切除术与EX-PRESS引流器植入术均可降低NVG患者眼压,但后者手术并发症较少、改善视力方面更有优势。
AIM:To investigate the impact of intravitreal conbercept injection on the aqueous humor levels of vascular endothelial growth factor(VEGF),interleukin-6(IL-6)and interleukin-8(IL-8)in patients diagnosed with neovascular glaucoma(NVG),and to evaluate the efficacy of conbercept in combination with different surgical modalities.METHODS:This study was conducted as a retrospective,case series investigation.A total of 102 patients(102 eyes)diagnosed with NVG from Jan.2019 to Feb.2020 were enrolled and randomized to trabeculectomy group(50 eyes of 50 cases)or EX-PRESS drain implantation group(52 eyes of 52 cases)3-5d after conbercept injections.The concentrations of VEGF,IL-6 and IL-8 in aqueous humor were determined by enzyme-linked immunosorbent assay(ELISA).The therapeutic efficacies of different surgical modalities were evaluated and compared by status of iris neovascularization,changes in postoperative intraocular pressure(IOP),improvement of visual acuity and incidence of complications.RESULTS:Decreases in aqueous humor concentrations of VEGF,IL-6 and IL-8 were observed at 3-5d after treatment of conbercept(all P<0.05).At 1,3d,1,3,6 and 12mo after surgery,the IOP levels of patients in both groups were significantly reduced compared to those before surgery(all P<0.05),and there was a statistically significant difference in IOP between the two groups at 3,6,and 12mo postoperatively(all P<0.05).At 6 and 12mo after surgery,patients treated with EX-PRESS drain implantation showed better visual acuity compared to patients treated with trabeculectomy(all P<0.05).There was no statistically significant difference in types and dosages of anti-glaucoma drugs administered to patients in different groups.At 12mo follow-up,success rate of surgery in the EX-PRESS drain implantation group(86.5%)was higher than that in the trabeculectomy group(70.0%),along with remarkably lower incidence rate of complications compared to that of the trabeculectomy group(P<0.05).CONCLUSION:The intravitreal injection of conbercept could down-regulat
作者
牛童童
邓月
刘毅
雷代坤
杨永利
Tong-Tong Niu;Yue Deng;Yi Liu;Dai-Kun Lei;Yong-Li Yang(Department of Ophthalmology,Xinjiang Military District General Hospital of Chinese People s Liberation Army,Urumchi 830000,Xinjiang Uygur Autonomous Region,China)
出处
《国际眼科杂志》
CAS
北大核心
2021年第11期1865-1869,共5页
International Eye Science
基金
新疆军区总医院北京路医疗区青年培育科研项目(No.2020jzbj1009)。
