玻璃体腔抗VEGF药物注射中两种眼压控制方法比较分析  

Comparison of two intraocular pressure control methods during vitreous injection of anti-VEGF drug

作　　者：周吕琴 姜波 王泽飞 王勇 史春生 Zhou Lvqin;Jiang Bo;Wang Zefei;Wang Yong;Shi Chunsheng(Department of Ophthalmology,Anhui Second People's Hospital,Hefei 230000,China)

机构地区：[1]安徽省第二人民医院眼科,合肥230000

出　　处：《临床眼科杂志》2022年第1期46-49,共4页Journal of Clinical Ophthalmology

基　　金：安徽省教育厅自然科学研究重点项目(KJ2019A1097);安徽省卫生厅科研计划项目(2018SEYL025)。

摘　　要：目的探讨两种眼压控制方法在玻璃体腔注射抗VEGF药物中的比较。方法前瞻性随机对照研究。玻璃体腔注射康柏西普的视网膜病变患者171例(171只眼)。所有患者随机分为3组:未做处理的对照组(A组,56例56只眼)、前房穿刺组(B组,58例58只眼)和甘露醇组(C组,57例57只眼),A组仅在玻璃体腔注射康柏西普,B组在玻璃体腔内注射康柏西普同时行前房穿刺,C组在玻璃体腔内注射康柏西普前30 min静脉滴注250 ml甘露醇。采用AccuPen手持式回弹眼压计,分别在注射前、注射后2 min、30 min、60 min、1 d及1周对患者进行眼压测量。最后,将收集的结果进行比较分析。结果与术前眼压比较,A组术后2 min眼压均值骤升至(41.04±5.84)mmHg,与B、C组同时间点眼压比较,差异有统计学意义(P<0.05);30 min时,眼压均值为(18.25±5.15)mmHg,与B、C组同时间点眼压比较,差异有统计学意义(P<0.05);60 min、1 d及1周时,与B、C组同时间点比较,差异无统计学意义(P>0.05);与术前眼压比较,B组术后各时间点眼压变化无统计学意义(P>0.05);与术前眼压比较,C组术后2 min眼压骤升至(32.77±3.80)mmHg,与B、C组同时间点眼压比较,差异有统计学意义(P<0.05);30、60 min,1 d及1周时,与术前比较,差异无统计学意义(P>0.05)。结论前房穿刺在玻璃体腔注射康柏西普术中控制眼压效果更佳。Objective To investigate the effects of two intraocular pressure(IOP)control methods during intravitreal injection of anti-VEGF drugs in affected eyes.Methods Prospective random-controlled study.A total of 171 patients with retinopathy who received vitreous injection of conbercept were included.All patients were randomly divided into three groups:the control group(group A,56 cases,56 eyes),anterior chamber puncture group(group B,58,58 eyes)and mannitol group(group C,57 cases,57 eyes).Participants in group A only received conbercept injection,group B received intravitreal injection of conbercept and anterior chamber puncture,group C received intravenous injection of 250ml mannitol at 30min before the intravetreal injection of conbercept.IOP was measured before the intravitreal injection and 2 min,30 min,60 min,1 d and 1 wk after the injection by Accu Pen tonometer.The collected results were analyzed and compared.Results Compared with preoperative IOP,the mean IOP of group A increased sharply to(41.04±5.84)mmHg at 2min after the operation,and the difference was statistically significant compared with group B and C at the same time(P<0.05).At 30 min,the mean IOP was(18.25±5.15)mmHg,which was statistically significant compared with group B and C at the same time(P<0.05).At 60 min,1 d and 1 week,there was no significant difference between group A with group B and C at the same time(P>0.05).Compared with preoperative IOP,there was no statistically significant difference in IOP at each time point after the operation in group B(P>0.05).The IOP of group C increased sharply to(32.77±3.80)mmHg at 2 min after the operation,which was significantly different compared with that of group B and C at the same time(P<0.05).There was no significant difference in IOP in group C at 30 min,60 min,1 d and 1 wk after the operation,as compared to that before the operation(P>0.05).Conclusions Anterior chamber puncture is more effective in controlling IOP during intravitreal injection of conbercept.

关 键 词：眼压 康柏西普 玻璃体腔注射 前房穿刺 甘露醇 

分 类 号：R774.1[医药卫生—眼科]