结膜下注射Bevacizumab治疗硅油填充眼角膜移植术后角膜新生血管  

Treatment of corneal neovascularization after corneal transplantation in silicone oil filled eye with subconjunctival injection of bevacizumab

作　　者：王文战[1] 杨惠春[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南郑州450052

出　　处：《眼外伤职业眼病杂志》2008年第9期699-703,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的评价结膜下注射bevacizumab（贝伐单抗，avastin）治疗硅油填充眼角膜移植术后角膜新生血管的临床效果和安全性。方法回顾性分析一组经结膜下注射bevacizumab 25 mg（1mE）治疗角膜新生血管的病例，患者均为复杂性眼外伤行角膜移植术后联合玻璃体切除及硅油填充眼，共12例12眼，bevacizumab注射后随访2．～6个月，平均4．26个月。患者接受角膜缘4个象限结膜下注射bevacizumab共25mg（1mL）治疗，观察注射前及注射后1周、2周及4周的视力、眼压及角膜新生血管面积的变化。结果注射后4周视力提高了0．01～0．02者6眼；占50％；提高了0．025～0．04者5眼，占41．7％；提高了0．05者1眼，占8．3％。注射后4周眼压不变者8眼，占66．67％，眼压升高2mmHg者2眼，占16．67％。眼压下降1mmHg（1mmHg=0．133kPa）者2眼，占16．67％。角膜新生血管面积减少50％以上者3眼，减少40％～49％者7眼，减少30％～39％者2眼。所有患者均未出现高眼压、葡萄膜炎或其他眼内和全身不良反应。结论结膜下注射bevacizumab对于抑制硅油填充眼角膜移植术后的角膜新生血管是一种较理想的选择，方法容易操作，并发症少，早期应用能获得更好的结果。但尚需进一步大样本多中心的临床随机对照研究。Objective To evaluate the safety and efficacy of bevacizumab subconjunctival use in corneal neovascularization after the corneal transplantation in silicone oil filled eye. Methods Through a retrospective analysis of a group of treatment cases of corneal neovascularization by injecting bevacizumab 25mg （1 mL） subeonjunctivally. All the cases, 12 eyes of 12 cases operated with vitroretinal surgery and silcon oil filled eyes, because of complex eye wound. After the injection, a follow-up visit of 2 - 6 months was made, on the average of 4 months. The cases received the treatment with the injection of bevacizumab 25 mg（1ml） under the 4 quadrant conjunctiva. Before the injection, and after it, abservations of the changes of the cases＇ visual acuity , intraocular pressure and the corneal neovascularization area were made , and each observation of each case lasted 1 week,2 weeks,4 weeks separately. Results 4 weeks after the injection,the visual acuity of 6 eyes, enhanced to 0.01 - 0.02 （50%） ; 5 eyes, enhanced to 0.025 - 0.04（41.7% ）, ;another one case enhanced up to 0.05（8.3% ）. intraocular pressure of 8 cases, stay unchanged 4 weeks after injection ; 2 cases, increased 2 mmHg while another 2 cases decreased 1 mmHg. 3 cases＇ corneal neovascularization area decreased over 50% ; 7 cases decreased 40% - 49% ; another 2 cases decreased 30% - 39%. All the cases have not had such symptoms as high intraocular pressure, uveitis,poor reaction of inner eyes or the whole body. Conclusions The injectiori of bevacizumab subconjunctival is an ideal choice to inhibit the corneal neovascularization after corneal transplantation of silicone oil filled eye. It is easy to operate with fewer complications. It can be more effective if used earlier. However, it still needs further big sample muhicentre clinical research.

关 键 词：BEVACIZUMAB 角膜新生血管 

分 类 号：R779.65[医药卫生—眼科]