玻璃体腔注射lucentis治疗白内障术后顽固性黄斑水肿的疗效  

Effect of intravitreal injection of lucentis for refractory macular edema after cataract surgery

作　　者：郑政[1] 刘丹宁[1] 周希瑗[1] 胡晓鹏[1] 武明星[1] 

机构地区：[1]重庆医科大学附属第二医院眼科,重庆400010

出　　处：《第三军医大学学报》2016年第20期2287-2290,共4页Journal of Third Military Medical University

摘　　要：目的通过玻璃体腔单次注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物lucentis观察治疗顽固性黄斑水肿的临床疗效和安全性。方法收集2014年7月至2015年7月在我科白内障超声乳化联合人工晶体植入术后发生顽固性黄斑水肿患者9例(10眼),病史均大于3个月。荧光素眼底血管造影(fundus fluoresceinangiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)检查确诊并排除黄斑相关疾病引起的黄斑水肿。患眼玻璃体腔单次注射lucentis 0.5 mg(0.05 m L),治疗后随访12周,对比观察治疗前后患眼视力、眼压、OCT及FFA改变。结果 9例患者10只眼治疗后1周视力明显提高,4、12周后视力稳定;与治疗前比较,差异均具有统计学意义(P<0.01)。OCT检查黄斑中心凹视网膜厚度(central foveal thickness,CFT),从治疗前(480±121)μm,下降至治疗后1周(293±58)μm,4、12周厚度分别保持在(231±23)、(235±35)μm,治疗前后比较,差异均具有统计学意义(P<0.01),所有患者均未出现眼内或全身不良反应。结论玻璃体腔注射lucentis治疗白内障术后顽固性黄斑水肿能明显改善患者视功能,减轻黄斑水肿,无副作用。Objective To observe the clinical efficacy and safety of single intravitreal injection of anti-vascular endothelial growth factor （VEGF） agent, lucentis, for refractory macular edema after cataract surgery. Methods Nine patients （10 eyes ）with refractory macular edema after cataract surgery （phacoemulsification combined with intraocular lens implantation）at our department from July 2014 to July 2015 were included in the study. All patients had medical history of refractory macular edema longer than 3 months, confirmed by examinations of optical coherence tomography （OCT） and fundus fluorescein angiography （FFA）. Macular edema caused by other macular-related disease were excluded, and patients had no any systemic and local operation contraindication. The central foveal thickness（CFT） before treatment were 480 ±121 ixm. For the affected eyes, single intravitreal injection of lucentis 0. 5 mg （ 0. 05 mL ） was administrated. Follow-up period continued for 12 weeks. The changes of visual acuity （ VA ） , intraocular pressure, OCT and FFA were compared before and after the treatment. Results The VA of 9 patients （10 eyes） was obviously improved in 1 week after treatment, with stable vision at the 4 and 12 weeks. The VA differences between the pre- and after lucentis injection were statistically significant（P 〈0. 01 ）. For the CFT measured by OCT,it dropped to 293 ±58 μm in 1 week after therapy, with the thickness of 231 ±23 μm and 235 ±35 μm at the 4 and 12 weeks, respectively. The differences of CFT before and after treatment were also statistically significant. Meanwhile, no patients experienced ocular or systemic adverse reactions. Conclusion Intravitreal injection of lucentis for refractory macular edema after cataract surgery can significantly improve the patients＇ visual function, and reduce macular edema with no side effect observed.

关 键 词：白内障术后 黄斑水肿 抗VEGF 视功能 LUCENTIS 

分 类 号：R774.5[医药卫生—眼科] R776.1[医药卫生—临床医学]