康柏西普联合睫状体冷凝和小梁切除术治疗晚期新生血管性青光眼  

Conbercept combined with trabeculectomy and cyclocryotherapy for advanced neovascular glaucoma

作　　者：裴亚欣 刘向玲[2] 宋子宣[2] 梁晓洁 王昕 PEI Yaxin;LIU Xiangling;SONG Zixuan;LIANG Xiaojie;WANG Xin(The Third Clinical College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Ophthalmology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三临床学院,河南省新乡市453003 [2]新乡医学院第三附属医院眼科,河南省新乡市453003

出　　处：《眼科新进展》2020年第9期875-878,共4页Recent Advances in Ophthalmology

摘　　要：目的观察康柏西普联合睫状体冷凝和小梁切除术综合治疗对晚期新生血管性青光眼(NVG)的短期疗效。方法选取新乡医学院第三附属医院眼科二病区2017年1月至2018年12月收治的晚期NVG患者23例23眼,均于康柏西普玻璃体内注射5~7 d后,行睫状体冷凝和小梁切除术联合治疗,术后随访6个月,观察手术成功率、眼压控制效果、抗青光眼药物使用情况及并发症发生情况。结果末次随访时,手术成功率为91.30%。注药后3 d患眼眼压为(35.16±5.15)mmHg(1 kPa=7.5 mmHg),明显低于注药前(42.21±6.72)mmHg;术后7 d、1个月、3个月、6个月眼压分别为(13.51±3.96)mmHg、(14.84±5.81)mmHg、(15.85±4.16)mmHg、(16.01±4.41)mmHg,明显低于术前(37.18±5.77)mmHg,差异均具有统计学意义(均为P<0.05)。术后7 d及1个月,使用3~5种抗青光眼药物者的比例分别为65.22%、43.48%,与术前的91.30%相比明显降低,差异均具有统计学意义(均为P<0.05);术后3个月和6个月,使用2种抗青光眼药物者的比例均为4.35%,不再使用抗青光眼药物者的比例均为95.65%。末次随访时,1眼眼球萎缩,1眼并发大泡性角膜病变,余均未见其他严重并发症发生。结论康柏西普联合睫状体冷凝和小梁切除术治疗晚期NVG手术成功率较高,能显著减少抗青光眼药物的使用和降低眼压,值得基层医院推广。Objective To observe the efficacy and safety of Conbercept combined with trabeculectomy and cyclocryotherapy in the treatment of advanced neovascular glaucoma(NVG).Methods Totally 23 eyes of 23 NVG patients from January 2017 to December 2018 were selected from the Second Department of Ophthalmology of the Third Affiliated Hospital of Xinxiang Medical University,and all patients were treated by trabeculectomy and cyclocryotherapy for 5-7 days after intravitreal injection of Conbercept.The follow-up period was six months after surgery.The success rate of operation,intraocular pressure control effect,the use of anti-glaucoma drugs and postoperative complications were observed.Results At the last follow-up,the success rate of operation was 91.30%;the intraocular pressure was(35.16±5.15)mmHg(1 kPa=7.5 mmHg),significantly lower than that before injection[(42.21±6.72)mmHg].The intraocular pressure was(13.51±3.96)mmHg,(14.84±5.81)mmHg,(15.85±4.16)mmHg,(16.01±4.41)mmHg on day 7,1 month,3 months,and 6months,respectively,significantly lower than that before injection[(37.18±5.77)mmHg],and the difference was statistically significant(all P<0.05).After 7 days and 1 month,the proportion of using 3-5 kinds of anti-glaucoma drugs was 65.22%and 43.48%respectively,which was significantly lower than that before operation(91.30%),and the difference was statistically significant(P<0.05).After 3 months and 6 months,the proportion of using 2 kinds of anti-glaucoma drugs was 4.35%,and the proportion of not taking anti-glaucoma drugs was 95.65%.At the last follow-up,1 eye had atrophy of eyeball,1 eye had bullous keratopathy,and no other serious complications were found.Conclusion Conbercept combined with trabeculectomy and cyclocryotherapy for neovascular glaucoma has a high success rate of operation and can significantly reduce the use of anti-glaucoma drugs and intraocular pressure,which is worthy of promotion in primary hospitals.

关 键 词：康柏西普 小梁切除术 睫状体冷凝术 新生血管性青光眼 

分 类 号：R775.3[医药卫生—眼科]