新生血管性青光眼综合治疗的临床效果  

Efficacy of combined treatment for neovascular glaucoma

作　　者：张雪梅[1] 都建英 马建军[1] 范玉霞 Zhang Xuemei;Du Jianying;Ma Jianjun;Fan Yuxia(Department of Ophthalmology,Gansu Provincial People＇ s Hospital,Lanzhou 730000,Chin;Department of Ophthalmology,the Second People＇ s Hospital of Dingxi,C.ansu 743000,Chin)

机构地区：[1]甘肃省人民医院眼科,兰州730000 [2]定西市第二人民医院,甘肃743000

出　　处：《中华眼外伤职业眼病杂志》2018年第7期485-488,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价新生血管性青光眼综合治疗的效果。方法新生血管性青光眼48例（49只眼）玻璃体内注射康柏西普，注射后3～7 d行广泛视网膜光凝（PRP）再行复合式小梁切除术或Ex-press引流器植入术，伴有白内障者行超声乳化＋Ex-press引流器植入术，玻璃体积血者行玻切＋PRP＋复合式小梁切除术。随访6个月，观察术后的视力、眼压、虹膜新生血管情况及并发症。结果49只眼接受玻璃体内注射康柏西普后3～5 d虹膜及前房角新生血管完全消退。术后末次随访视力提高者18只眼（36.7%），视力未变者31只眼（63.3%），无视力下降者。术前平均眼压（42.60±6.12）mmHg（1mmHg＝0.133 kPa），术后末次随访平均眼压（15.26±4.70）mmHg。完全成功38只眼（77.6%），11只眼（22.4%）部分成功，无虹膜新生血管复发病例。结论新生血管性青光眼根据不同临床特点选择个性化综合治疗方案，效果良好。ObjectiveTo evaluate the efficacy of combined treatment for neovascular glaucoma（NVG）.MethodsForty-nine eyes of 48 patients with NVG were treated with intravitreal Conbercept 0.5 mg （0.05 ml） injection firstly and panretinal photocoagulation （PRP） 3-7days after injection. Then they underwent compound trabeculectomy combined with mitomycin C or the Ex-press implantation. Patients with cataract underwent phacoemulsification combined Ex-press implantation. Vitrectomy and PRP was performed for patients combined with vitreous hemorrhage.Iris neovascularization condition, the intraocular pressure, visual acuity and complications after surgery were recorded.The followed-up time was 6 months.ResultsThe new vessels of iris and anterior chamber angle were completely regressed 3-5 days after intravitreal injection of Conbercept in 49 eyes.Visual acuity at the last follow-up time improved in 18 eyes（36.7%）, unchanged in 31 eyes（63.3%）. The pre-surgery IOP was （42.60±6.12） mmHg （1 mmHg=0.133 kPa）, the postoperative IOP was （15.26±4.70）mmHg.Successful rate of surgery was 77.6%（38/49）. Eleven eyes were partially successful. No recurrence of neovascularization happened. ConclusionAccording to different clinical characteristics of neovascular glaucoma, the individualized combined treatment is chose.

关 键 词：青光眼 新生血管性 康柏西普 小梁切除术 复合式 引流器植入术 Ex-press 

分 类 号：R779.6[医药卫生—眼科]