玻璃体腔注射雷珠单抗和康柏西普联合青光眼引流阀植入治疗新生血管性青光眼的疗效

发布时间：2018-01-30 05:10

本文关键词： 新生血管性青光眼雷珠单抗康柏西普青光眼引流阀　出处：《吉林大学学报(医学版)》2017年06期 　论文类型：期刊论文

【摘要】：目的:观察玻璃体腔注射雷珠单抗和康柏西普联合青光眼引流阀(AGV)植入治疗新生血管性青光眼(NVG)的疗效。方法:将68例NVG患者根据AGV植入术前是否进行玻璃体腔注药以及药物的不同分为雷珠单抗组(n=26)、康柏西普组(n=21)和对照组(n=21),分别于AGV植入术前3~7d行玻璃体腔注射雷珠单抗(10g·L~(-1))或者康柏西普(10g·L~(-1)),待虹膜新生血管消退后行AGV植入术;对照组患者给予药物或前房穿刺后待眼压(IOP)平稳行AGV植入术;对屈光介质清晰的患者,玻璃体腔注药和AGV术前行全视网膜光凝术(PRP),如果屈光介质不清晰,先应用抗血管内皮生长因子(VEGF)药物治疗,待能窥清眼底时再行PRP。结果:雷珠单抗组、康柏西普组和对照组患者术后平均眼压均较术前降低(P0.01);3组患者术后平均抗青光眼药物数目均较术前明显减少(P0.01);3组患者术后不同时间点手术成功率比较差异无统计学意义(P0.05);术后1个月、3个月雷珠单抗组和康柏西普组患者最佳矫正视力(BCVA)均明显优于对照组(P0.05);雷珠单抗组和康柏西普组患者术后不同时间点各项并发症发生率比较差异均无统计学意义(P0.05)。结论:玻璃体腔注射抗VEGF药物联合AGV植入术可以有效、安全地治疗NVG,短期内提高患者视力,快速减轻患者疼痛、减少手术并发症。
[Abstract]:Objective: to observe the effect of vitreous injection of Leizhu McAb and Compathep combined with glaucoma drainage valve AGV on the treatment of neovascular glaucoma with NVG. Methods: Sixty-eight patients with NVG were divided into two groups according to whether or not intravitreous injection was performed before AGV implantation and the drug was divided into two groups: Threzumab group (n = 26). The control group and the control group were divided into two groups, the control group and the control group (n = 21). A vitreous injection of 10 g 路L ~ (-1) and 10 g 路L ~ (-1) of triazepine (10 g 路L ~ (-1)) was performed 3 days before AGV implantation. After iris neovascularization subsided, AGV implantation was performed. The patients in the control group were treated with drugs or IOP after anterior chamber puncture. AGV implantation was performed smoothly. For the patients with clear refractive medium, intravitreal injection and AGV were performed before the whole retinal photocoagulation. If the refractive medium was not clear, anti-vascular endothelial growth factor (VEGF) drugs were used first. Results: the mean IOP of the patients in the Leizhu McAb group, Compactopril group and control group was lower than that in the preoperative group. The average number of anti-glaucoma drugs in the three groups was significantly lower than that before operation (P 0.01). There was no significant difference in the success rate between the three groups at different time points after operation (P 0.05). At 1 month, 3 months after operation, the best corrected visual acuity (BCVA) was significantly better in the Lei Zhu McAb group and the Compactopril group than in the control group (P 0.05). There was no significant difference in the incidence of complications at different time points between the Leizhu McAb group and the Compactopril group (P 0.05). Conclusion: intravitreal injection of VEGF combined with AGV implantation is effective. Safe treatment of NVG, short-term improvement of visual acuity, rapid relief of patients' pain, and reduction of surgical complications.
【作者单位】：大连医科大学附属第一医院眼科;
【基金】：国家自然科学基金资助课题(81300737,81271022)
【分类号】：R775
【正文快照】： 新生血管性青光眼(neovascular glaucoma,NVG)是源于虹膜与前房角新生血管(neovascularization,NV)收缩牵拉,导致房角进行性关闭,引起眼压(intraocular pressare,IOP)升高造成不可逆性视功能损害的继发性青光眼,属于难治性青光眼中最为棘手的一种,多继发于眼底及眼前段缺血性

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