玻璃体腔注射雷珠单抗对NVG虹膜新生血管消退及眼压控制的效果  

Effect of vitreous cavity injection of Lucentis on iris neovascularization fade and intraocular pressure control in neovascular glaucoma patients

作　　者：吴秋菊[1] 刘国华[1] 尚荣辉[1] 王巍[1] 胡庆军 

机构地区：[1]民航总医院眼科,北京100123

出　　处：《检验医学与临床》2017年第6期778-780,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨玻璃体腔注射雷珠单抗对新生血管性青光眼(NVG)虹膜新生血管消退及眼压控制的效果。方法将2013年5月至2014年5月在该院就诊的34例NVG(35眼)患者玻璃体腔注射雷珠单抗,3~5d后行Ex-press引流植入术;术后随访6个月,观察患者视力、眼压、新生血管变化情况,并记录患者并发症发生率。结果注射雷珠单抗3~5d后的34例(35眼)NVG患者新生血管完全消退,随访6个月,无新生血管复发病例。34例患者手术完全成功29例(85.29%),条件成功5例(14.71%);术后1、2、3d,1、2、3周,以及1、3、6个月患者眼压显著低于手术前,手术前后各时段比较,差异均有统计学意义(P<0.05)。术后1、2周与术前视力比较,差异无统计学意义(P>0.05),术后3周,1、3、6个月视力均显著高于术前(P<0.05)。术后有6例患者出现浅前房,2例患者出现脉络膜脱离,3例患者术后第2~3天前房出现少量出血,对症处理后均有所好转。结论玻璃体内注射雷珠单抗后联合Ex-press植入术能够有效控制NVG患者眼压,改善患者视功能,且进一步减少术中并发症发生率,是一种安全有效的治疗方案。Objective To explore the effect of vitreous cavity injection of Lucentis on iris neovascularization fade and intraocular pressure control in the patients with neovascular glaucoma（NVG）.Methods Thirty-four cases（35eyes）of NVG in our hospital from May 2013 to May 2014 were given the vitreous cavity injection of Lucentis and performed the Ex-press drainage implant operation after 3-5d;after operation the cases were followed up for 6months.The visual acuity,intraocular pressure and neovascularization fade were observed.The occurrence rate of complications were recorded.Results Neovascularizations in 34 NVG cases（35eyes）were completely subsided on 3-5dafter Lucentis injection,no recurrence cases occurred by 6-month follow up.Among 34 cases,29cases（85.29%）were complete success and 5cases（14.71%）were conditional success;the intraocular pressure on postoperative 1,2,3dand at 1,2,3weeks,1,3,6months was significantly lower than that before surgery（P〈0.05）,there were statistically significant differences among different time periods before and after operation（P〈0.05）.The visual acuity had no statistical difference between postoperative 1,2 weeks and before operation（P〉0.05）,the visual acuity at postoperative 3 weeks,1,3,6months was significantly higher than that before operation（P〈0.05）.After operation,there were 6cases of shallow anterior chamber,2cases of choroidal detachment and 3cases of anterior chamber small amount of bleeding on postoperative 2-3d,all were improved by symptomatic treatment.Conclusion Vitreous cavity injection of Lucentis combined with Ex-press implantation can effectively and safely control intraocular pressure in NVG patients,improves the patients′visual acuity,moreover further reduces the incidence of intraoperative complications,which is a safe and effective treatment scheme.

关 键 词：雷珠单抗 新生血管性青光眼 新生血管 眼压 Ex-press植入术 

分 类 号：R775[医药卫生—眼科]