雷珠单抗联合小梁切除术及视网膜光凝治疗新生血管性青光眼临床分析  

Clinical analysis of ranibizumab combined with trabeculectomy and retinal photocoagulation for the treatment of neovascular glaucoma

作　　者：马军艳[1] 赵学军[1] Ma Junyan;Zhao Xuejun(Department of Ophthalmology,Central Hospital of Jiaozuo Coal Industry,Henan 454150,China)

机构地区：[1]焦作煤业集团中央医院眼科,河南454150

出　　处：《中华眼外伤职业眼病杂志》2021年第6期460-466,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察雷珠单抗联合小梁切除术及视网膜光凝术治疗新生血管性青光眼的临床效果。方法回顾性分析2018年1月至2020年2月焦作煤业集团中央医院眼科新生血管性青光眼128例(128眼)的临床资料。按治疗方式分为两组,各64例(64眼)。研究组采用雷珠单抗玻璃体内注射联合小梁切除术及广泛视网膜光凝;对照组采用小梁切除术联合广泛视网膜光凝。术后比较两组治疗效果。术后随访6个月。结果研究组总有效率为96.88%(62/64),高于对照组的85.94%(55/64)(χ^(2)=4.873,P=0.027);术后1周、1个月研究组视力及房水色素上皮衍生因子水平高于对照组,眼压、房水IL-6、IL-8、高敏C反应蛋白、血管内皮生长因子和促红细胞生成素水平低于对照组(P<0.05);研究组并发症发生率为6.25%(4/64),低于对照组的18.75%(12/64)(χ^(2)=4.571,P=0.033);术后6个月研究组疾病复发率低于对照组(χ^(2)=4.206,P=0.040)。结论雷珠单抗联合小梁切除术及广泛视网膜光凝治疗新生血管性青光眼效果显著,安全性高。Objective To observe the clinical efficacy of ranibizumab combined with trabeculectomy and retinal photocoagulation for the treatment of neovascular glaucoma.Methods The clinical data of 128 eyes of 128 patients with neovascular glaucoma in the Central Hospital of Jiaozuo Coal Industry from Jan.2018 to Feb.2020 were retrospectively analyzed.The patients were divided into two groups based on the treatment methods,64 eyes of 64 cases in each group.The study group were treated with ranibizumab and panretinal photocoagulation combined with trabeculectomy,and the control group were treated with panretinal photocoagulation combined with trabeculectomy.The postoperative efficacy between the two groups were compared.The follow-up time was 6 months.Results The total effective rate of the study group was 96.88%(62/64),which was higher than 85.94%(55/64)of the control group(χ^(2)=4.873,P=0.027).At 1 week and 1 month after surgery,the visual acuity and the pigment epithelium derived factor level of aqueous humor of the study group were higher than those of the control group,while the levels of intraocular pressure,aqueous humor IL-6,IL-8,High-sensitivity C-reactive protein,vascular endothelial growth factor and erythropoietin were lower than those of the control group(P<0.05).The rate of complication in the study group was 6.25%(4/64),which was lower than that 18.75%(12/64)of the control group(χ^(2)=4.571,P=0.033).At 6 months after surgery,the rate of disease recurrence in the study group was lower than that of the control group(χ^(2)=4.206,P=0.040).Conclusion The treatment of neovascular glaucoma with ranibizumab and panretinal photocoagulation combined with trabeculectomy have significant efficacy and high safety.

关 键 词：青光眼 新生血管性 雷珠单抗 光凝 视网膜 广泛 小梁切除术 因子 炎性 血管内皮生长因子 

分 类 号：R779.6[医药卫生—眼科]