玻璃体内注射康柏西普在中重型非增殖期糖尿病视网膜病变合并白内障手术患者中的应用效果  

Application effect of intravitreal injection of conbercept in patients with moderate and severe non-proliferative diabetic retinopathy complicated with cataract surgery

作　　者：伊恩晖[1] 杜兆江 杨格强[1] 肖潇[1] 贺金刚[1] 王晟宇 YI Enhui;DU Zhaojiang;YANG Geqiang;XIAO Xiao;HE Jingang;WANG Shengyu(Ophthalmology Department,Xi'an Central Hospital,Xi'an 710003,China)

机构地区：[1]西安市中心医院眼科,陕西西安710003

出　　处：《临床医学研究与实践》2022年第12期17-21,共5页Clinical Research and Practice

基　　金：西安市科技计划项目[No.20YXYJ0008(5)];2022年西安市中心医院科研基金资助项目(No.2022YB04)。

摘　　要：目的评价玻璃体内注射康柏西普(IVC)在中重型非增殖期糖尿病视网膜病变(NPDR)合并白内障手术患者中的应用效果。方法选取2019年1月至2021年3月于我院进行手术治疗的中重型NPDR合并白内障患者42例,同一患者的双眼按不同方法进行处理,将行白内障超声乳化+人工晶体植入术治疗的纳入P+I组(42眼),将行白内障超声乳化+人工晶体植入术,术后即刻行IVC治疗的纳入P+I+IVC组(42眼)。比较两组术前、术后1 d、术后1周及术后1、3、6个月的最佳矫正视力(BCVA)、眼压、黄斑中心凹下视网膜厚度(SFRT);术前及术后1、3、6个月的光学相干断层扫描血管成像(OCTA)黄斑区血管密度(VD),虹膜新生血管及并发症发生情况。结果术后1 d、1周及术后1、3、6个月,两组的LogMAR BCVA均较术前有不同程度的改善(P<0.05);术后1 d、1周,P+I+IVC组的LogMAR BCVA优于P+I组,差异具有统计学意义(P<0.05)。术后1 d,P+I+IVC组的眼压显著高于P+I组,差异具有统计学意义(P<0.05)。术后1 d、1周、1个月,P+I+IVC组的SFRT均显著小于术前,P+I组均显著大于术前,且P+I+IVC组显著小于P+I组,差异具有统计学意义(P<0.05)。术后3、6个月,P+I组的黄斑区VD显著低于术前及P+I+IVC组,差异具有统计学意义(P<0.05)。P+I+IVC组的虹膜新生血管发生率显著低于P+I组,球结膜下出血发生率显著高于P+I组,差异具有统计学意义(P<0.05)。结论白内障手术中联合IVC应用于中重型NPDR合并白内障患者中的疗效较好,可降低和延缓白内障术后视网膜及新生血管并发症的发生。Objective To evaluate the application effect of intravitreal injection of conbercept(IVC)in patients with moderate and severe non-proliferative diabetic retinopathy(NPDR)complicated with cataract surgery.Methods A total of 42 patients with moderate and severe NPDR complicated with cataract who underwent surgery in our hospital from January 2019 to March 2021 were selected.The eyes of one patient were treated according to different methods.Eyes underwent cataract phacoemulsification+intraocular lens implantation were included in P+I group(42 eyes),and eyes underwent cataract phacoemulsification+intraocular lens implantation and received IVC immediately after operation were included in P+I+IVC group(42 eyes).The best corrected visual acuity(BCVA),intraocular pressure,subfoveal retinal thickness(SFRT)before operation,at 1 d,1 week and 1,3,6 months after operation;macular vascular density(VD)of optical coherence tomography angiography(OCTA)before operation,and at 1,3,6 months after operation,iris neovascularization and complications were compared between the two groups.Results At 1 d,1 week and 1,3,6 months after operation,the LogMAR BCVA of the two groups improved to varying degrees compared with that before operation(P<0.05);one day and one week after operation,LogMAR BCVA in the P+I+IVC group was better than that in the P+I group,and the difference was statistically significant(P<0.05).One day after operation,the intraocular pressure in the P+I+IVC group was significantly higher than that in the P+I group,and the differencs was statistically significant(P<0.05).One day,one week and one month after operation,the SFRT of the P+I+IVC group was significantly smaller than that before operation,that of the P+I group was significantly larger than that before operation,that of the P+I+IVC group was significantly smaller than the P+I group,and the difference was statistically significant(P<0.05).At 3 and 6 months after operation,the macular VD in the P+I group was significantly lower than that before operation and the P+I+

关 键 词：非增殖期糖尿病视网膜病变 白内障手术 玻璃体内注射康柏西普 最佳矫正视力 血管密度 

分 类 号：R774[医药卫生—眼科]