玻璃体切除联合引流阀植入术治疗新生血管性青光眼  

Vitrectomy combined with drainage valve implantation for the treatment of neovascular glaucoma

作　　者：焦婷 万光明[1] 梁申芝[1] 钱诚[1] 王炯[1] 杨会琴[1] Jiao Ting;Wan Guangming;Liang Shenzhi;Qian Cheng;Wang Jiong;Yang Huiqin(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2020年第5期321-324,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技创新杰出人才项目(184200510005);河南省自然科学基金(182300410363)。

摘　　要：目的评估抗VEGF药物辅助玻璃体切除联合引流阀植入术治疗增生性糖尿病视网膜病变(PDR)继发新生血管性青光眼(NVG)的临床效果。方法采用回顾性研究。收集郑州大学第一附属医院2017年10月至2019年9月玻璃体切除联合引流阀植入术治疗PDR继发NVG者36例(36只眼)的临床资料。所有患者术前2~6天行玻璃体内注射雷珠单抗0.05 ml(0.5 mg),随访3个月,观察术后1周、1个月和3个月的最佳矫正视力、眼压及并发症情况。结果术前平均眼压为(40.50±7.05)mmHg,术后1周、1个月和3个月平均眼压为(13.44±3.21)mmHg、(16.67±4.34)mmHg和(15.00±2.74)mmHg(1 mmHg=0.133 kPa)。术后各随访点平均眼压较术前明显下降,差异有统计学意义(F=273.227,P=0.000)。术前最佳矫正视力(logMAR)为2.21±0.43,术后1周、1个月和3个月的最佳矫正视力为1.88±0.56、1.65±0.57和1.53±0.60,术后各随访时间点最佳矫正视力均较术前明显提高,差异有统计学意义(F=10.797,P=0.000)。术后出现浅前房5例,前房积血5例,均未处理,1周后自行好转,无严重并发症发生。结论抗VEGF药物辅助玻璃体切除联合引流阀植入术治疗PDR继发NVG安全有效。Objective To evaluate the clinical efficacy of anti-VEGF drug assisted vitrectomy combined with drainage valve implantation for the treatment of neovascular glaucoma(NVG)secondary to proliferative diabetic retinopathy(PDR).Methods This was a retrospective study.The data of 36 eyes of 36 cases with NVG secondary to PDR treated with vitrectomy combined with drainage valve implantation from Oct.2017 to Sep.2019 in the First Affiliated Hospital of Zhengzhou University were collected.All cases reveived intravitreal injection of anti-VEGF 0.05 ml(0.5 mg)at 2-6 days before surgery.The follow-up time was 3 months.The best corrected visual acuity,intraocular pressure and complications were observed at 1 week,1 and 3 months after operation.Results The mean intraocular pressure before operation was(40.50±7.05)mmHg(1 mmHg=0.133 kPa).The mean intraocular pressure at 1 week,1 and 3 months after operation were(13.44±3.21)mmHg,(16.67±4.34)mmHg and(15.00±2.74)mmHg.The mean intraocular pressure at each follow-up point after operation was significantly lower than that before operation,and the difference was statistically significant(F=273.227,P=0.000).The best corrected visual acuity(BCVA,logMAR)before operation was 2.21±0.43.The BCVA at 1 week,1 and 3 months after operation were 1.88±0.56,1.65±0.57 and 1.53±0.60.The BCVA,at each follow-up point was significantly higher than that before operation,and the difference was statistically significant(F=10.797,P=0.000).There were complications such as shallow anterior chamber in 5 cases and hyphema in 5 cases postoperatively,which self-improved in 1 week without treatment.No serious complication occurred.Conclusion Anti-VEGF drug assisted vitrectomy combined with drainage valve implantation is safe and effective for the treatment of NVG secondary to PDR.

关 键 词：糖尿病视网膜病变 增生性 青光眼 新生血管性 玻璃体切除术 植入术 引流阀 青光眼 

分 类 号：R779.6[医药卫生—眼科]