雷珠单抗联合多重手术与睫状体光凝术治疗新生血管性青光眼的疗效比较  

Comparison of clinical efficacy of intravitreal ranibizumab combined surgeries and cyclophotocoagulation for neovascular glaucoma

作　　者：夏沁韵 陈震[1] 邢怡桥[1] XIA Qin-Yun;CHEN Zhen;XING Yi-Qiao(The Eye Center,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China)

机构地区：[1]武汉大学人民医院眼科中心

出　　处：《眼科新进展》2019年第12期1149-1152,共4页Recent Advances in Ophthalmology

基　　金：湖北省卫生计生委重点支撑项目(编号:WJ2017Z004)~~

摘　　要：目的比较雷珠单抗联合超声乳化白内障吸出术、玻璃体切割术、全视网膜激光光凝术、镜下睫状体光凝术与单纯经巩膜外睫状体光凝术治疗新生血管性青光眼(neovascular glaucoma,NVG)的临床疗效。方法回顾性分析2016年12月至2018年12月在武汉大学人民医院眼科中心就诊的35例(35眼)NVG患者资料。将所有患者按手术方式不同分为试验组和对照组,试验组15例,对照组20例。试验组行雷珠单抗玻璃体内注射联合超声乳化白内障吸出术、玻璃体切割术、全视网膜激光光凝术、镜下睫状体光凝术,对照组行巩膜外睫状体光凝术,比较术后1周、1个月、3个月两组治疗后的眼压、视力、虹膜新生血管及并发症等情况。结果两组患者术前基线资料比较差异均无统计学意义(均为P>0.05)。所有患者术后1周、1个月、3个月眼压均明显下降,两组患者手术前后眼压比较差异均有统计学意义(均为P<0.05)。术后1周对照组患者眼压高于试验组,差异有统计学意义(P<0.05),术后1个月、3个月两组差异均无统计学意义(P=0.923、0.738)。试验组视力改善率60.0%,对照组视力改善率10.0%,两组术后视力比较差异有统计学意义(P<0.05)。试验组虹膜新生血管消失率33.3%,对照组虹膜新生血管消失率10.0%,两组患者术后3个月虹膜新生血管情况比较,差异有统计学意义(P<0.05)。两组患者并发症复发率、眼球萎缩率差异均有统计学意义(均为P<0.05)。结论雷珠单抗联合超声乳化白内障吸出术、玻璃体切割术、全视网膜激光光凝术、镜下睫状体光凝术与单纯巩膜外睫状体光凝术相比,可有效减少虹膜新生血管的形成,保存部分视力,降低低眼压及眼球萎缩等并发症风险。Objective To compare the clinical efficacy of ranibizumab combined phacoemulsification,vitrectomy,panretinal photocoagulation,endoscopic cyclophotocoagulation and cyclophotocoagulation for neovascular glaucoma(NVG).Methods Thirty five eyes of 35 patients with neovascular glaucoma(NVG) from December 2016 to December 2018 in the Eye center,Renmin Hospital of Wuhan University were retrospectively analyzed.The patients were divided into an experimental group(15 patients 15 eyes) and control group(20 patients 20 eyes) according to the types of different operations.The experimental group was treated with ranibizumab combined phacoemulsification,vitrectomy,panretinal photocoagulation,endoscopic cyclophotocoagulation.The control group was treated with cyclophotocoagulation.The changes in intraocular pressure(IOP),visual acuity,iris neovascularization and adverse reactions were compared between the two groups at the end of 1 week,1 month and 3 months after surgery.Results There were no statistical differences in the preoperative baseline data between the two groups(all P>0.05).However,all patients had a significant decrease in IOP at 1 week,1 month and 3 months after operation,and there were significant differences between the two groups before and after operation(all P<0.05).The IOP of the control group was higher than that of experimental group at 1 week after operation,there was significant difference between the two groups(P<0.05),but no significant differences in 1 and 3 months after operation(P=0.923,P=0.738).The visual acuity improvement rate was 60.0% in the experimental group and 10.0% in the control group.The difference between the two groups was statistically significant(P<0.05).The disappearance rate of iris neovascularization was 33.3% in the experimental group and 10.0% in the control group.There was a significant difference in iris neovascularization between the two groups 3 months after operation(P<0.05).The differences in complication recurrence rate and the atrophy rate of eyeball between the two groups

关 键 词：新生血管性青光眼 雷珠单抗超声乳化白内障吸出术 玻璃体切割术 全视网膜激光光凝术 镜下睫状体光凝术 单纯巩膜外睫状体光凝术 

分 类 号：R775.3[医药卫生—眼科]