玻璃体腔注射雷珠单抗联合23G玻璃体切除治疗新生血管性青光眼疗效观察  

Clinical effect of intravitreal injection of ranibizumab combined with 23G vitrectomy in treatment of neovascular glaucoma

作　　者：郑纯[1] 李学喜[2] 陈佳娜[2] 

机构地区：[1]中国人民解放军第105医院眼科,安徽合肥230031 [2]中国人民解放军第180医院眼科,福建泉州362000

出　　处：《海南医学》2015年第21期3154-3156,共3页Hainan Medical Journal

摘　　要：目的 探索玻璃体腔注射雷珠单抗联合23G微创玻璃体切除、全视网膜激光光凝治疗新生血管性青光眼的效果和安全性.方法 15例（15只眼）新生血管性青光眼患者采取玻璃体腔注射雷珠单抗1.25 mg/0.05 ml,一周后观察前房角及虹膜表面新生血管消失或减退,然后行23G微创玻璃体切除、全视网膜激光光凝联合硅油填充治疗.术后6～12个月随访眼压及眼部情况.结果 手术均顺利,所有患者均未发生严重并发症.术前平均眼压（43.87±8.65） mmHg,术后一周为（24.56±4.56） mmHg,6个月时为（16.21±3.32） mmHg,12个月时为（18.21±5.32） mmHg,术后平均眼压分别与术前比较差异均具有统计学意义（P〈0.05）.12只眼眼压控制在正常范围,2只眼需加用2种抗青光眼药物,眼压〈21 mmHg,1只眼加用抗青光眼药物后眼压〈21 mmHg.结论 玻璃体腔注射雷珠单抗联合23G微创玻璃体切除、全视网膜激光光凝、硅油填充是治疗绝对期新生血管性青光眼的一种相对安全、有效的方法.Objective To explore the efficacy and safety of intravitreal injection of ranibizumab combined with 23G minimally invasive vitrectomy, panretinal photocoagulation, silicone oil in the treatment of neovascular glau-coma. Methods Fifteen patients （15 eyes） with absolute neovascular glaucoma were enrolled in the study, which were treated with intravitreal injection of ranibizumb 1.25 mg/0.05 ml, followed by 23G minimally invasive vitrecto-my and panretinal photocoagulation after a week based on the observation of disappear or decline of anterior chamber angle and the surface of iris neovascularization. All the patients received silicone oil tamponade. Postoperative intraoc-ular pressure （IOP） and ocular situation during the follow-up of 6-12 months were observed. Results The operation was successful in all the patients, with no severe complication occurred. The mean IOP level was （43.87±8.65） mmHg before the operation, （24.56 ± 4.56） mmHg one week after operation, （16.21 ± 3.32） mmHg 6 months after operation, （18.21±5.32） mmHg 12 months after operation, and the levels after operation were significantly lower than that before operation （P〈0.01）. Twelve eyes had the IOP controlled in the normal range, 2 eyes applied 2 kinds of anti-glauco-ma drugs and had the IOP controlled〈21 mmHg, and 1 eye applied anti-glaucoma drug and had the IOP still IOP〈21 mmHg. Conclusion Intravitreal injection of ranibizumb combined with 23G minimally invasive vitrectomy, pan-retinal photocoagulation, silicone oil tamponade is a relatively safe, effective method for the treatment of absolute phase of neovascular glaucoma.

关 键 词：雷珠单抗 23G玻璃体切除 新生血管性青光眼 视网膜光凝 硅油填充 

分 类 号：R775[医药卫生—眼科]