Bevacizumab玻璃体内注射联合视网膜光凝及冷凝治疗新生血管性青光眼

发布时间：2018-08-20 07:26

【摘要】：目的观察Bevacizumab玻璃体内注射联合视网膜光凝或前部视网膜冷凝治疗新生血管性青光眼的临床疗效。方法31例(31眼)新生血管性青光眼患者接受治疗。31眼玻璃体内注射0.05 mL Bevacizumab后行视网膜光凝,6眼因屈光间质混浊予以后极部视网膜光凝术后行巩膜外冷凝,术后随访6个月,观察眼压、视力及虹膜新生血管变化。结果虹膜表面新生血管22例术后3 d完全消退,9例明显变细;术后7 d后完全消退。术后1周、1个月、3个月、6个月平均眼压分别为23.68 mmHg(1 kPa=7.5 mmHg)、22.35 mmHg、18.27 mmHg、16.53 mmHg。术后1个月,23例视力提高,8例视力无变化,术前术后最佳矫正视力比较,差异均有统计学意义(均为P0.05)。23例眼压稳定,5例应用噻吗心胺、派立明滴眼后眼压维持在正常范围,3例眼压未控制,其中1例因无光感行睫状体冷冻术,2例行青光眼阀植入后眼压稳定。结论 Bevacizumab玻璃体内注射联合视网膜光凝及冷凝治疗新生血管性青光眼能改善视网膜缺血状态,有效降低眼压,并发症少,为目前治疗新生血管性青光眼安全、有效的治疗方法。
[Abstract]:Objective to observe the clinical effect of intravitreous injection of Bevacizumab combined with retinal photocoagulation or anterior retinal condensation in the treatment of neovascular glaucoma. Methods Thirty-one patients (31 eyes) with neovascular glaucoma were treated with intravitreous injection of 0. 05 mL Bevacizumab. 6 eyes were treated with retinal photocoagulation after posterior polar retinal photocoagulation due to refractive interstitial opacification and followed up for 6 months. Intraocular pressure, visual acuity and iris neovascularization were observed. Results 22 cases of iris surface neovascularization disappeared completely 3 days after operation, 9 cases became thin and 7 days after operation completely disappeared. The mean intraocular pressure at 1 week, 1 month, 3 months and 6 months after operation was 23.68 mmHg (1 kPa=7.5 mmHg) and 22.35 mmHg, 18.27 mmHg, 16.53 mmHg, respectively. Visual acuity was improved in 8 cases 1 month after operation. The difference of the best corrected visual acuity before and after operation was statistically significant (P0.05). 23 cases with stable intraocular pressure were treated with timoxifen in 5 cases. Intraocular pressure (IOP) was maintained within normal range in 3 cases. Intraocular pressure was stable after glaucoma valve implantation in 1 case after ciliary body cryopreservation because of lack of light sensation. Conclusion Intravitreous injection of Bevacizumab combined with retinal photocoagulation and condensation can improve retinal ischemia, reduce intraocular pressure and reduce complications. It is a safe and effective method for the treatment of neovascular glaucoma.
【作者单位】：潍坊医学院附属医院眼科;潍坊医学院附属医院关节外科;
【分类号】：R779.6

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