玻璃体腔注射雷珠单抗联合小梁切除术治疗新生血管性青光眼疗效观察

目的观察玻璃体腔注射雷珠单抗（Lucentis）联合复合式小梁切除术治疗新生血管性青光眼的疗效。方法对17例（17只眼）新生血管性青光眼行玻璃体腔注射Lucentis 0.50 mg/0.05 ml,8~14 d后行复合式小梁切除术。观察玻璃体腔注射Lucentis后虹膜及房角新生血管消退的时间、眼压的变化以及复合式小梁切除术后视力和眼压的变化。术后随访8~12个月。结果玻璃体腔注射Lucentis后,13只眼虹膜新生血管1周内完全消退,4只眼2二周内完全消退。注药前平均眼压（39.56±10.12）mm Hg,注药后1周平均眼压（38.62±8.35）mm Hg与注药前比较眼压变化无统计学意义（t=0.951,P〉0.05）。小梁切除术后1周眼压（10.43±6.12）mm Hg,最后一次随访眼压（13.61±4.31）mm Hg,与术前比较差异均有统计学意义（t=21.362、19.817,P均﹤0.01）。末次随访时12只眼视力提高,5只眼视力未变。结论玻璃体腔注射雷珠单抗联合复合式小梁切除术能有效地控制眼压,保护视功能。

The treatment of neovascular glaucoma by intravitreous injection of Lucentis combined with trabeculectomy and mitomycin C

Objective To observe the effect of Lucentis intravitrcous injection combined with ulectomy and MMC administration on neovascular glaucoma （NVG）. Methods Seventeen eyes of 17 patients with angle-elesure NVG were treated with intravitreous injection of Lucentis 0.50m8/0.05ml. Trabeculectomy were performed in 8 ± 14 days with MMC application. The regression of iris neovascularization and changes in intraocular pressure （ IOP ） were observed after the injection. Best corrected visual acuity was followed after trabeculectomy. Patients were followed-up for 8 - 12 months. Results Irls neovascularizatlon completely regressed within one week in 13 eyes and within 2 weeks in the other 4 eyes af- ter the injection of Lucentis. The average IOP was （ 39.56 ± 10. 12 ） mm Hg before injection, and （ 38.62 ± 8.35 ） mm- Hg in a week after injection. The IOP had no significant changes before and after injection （ t = 0.951, P 〉 0. 05 ）. The IOP was （ 10.43 ± 6. 12 ） mmHg in one week after traboculectomy, and （ 13.61 ± 4.31 ） mmHg in the last follow-up vis- it. Compared with the preoperative measurements, there was a significant reduction in IOP （ t = 21.362 at 1 week, t = 19. 817 at 2 weeks, both P 〈 0.01 ）. The best corrected visual acuity improved in 12 eyes, remained unchanged in 5 eyes at eyes follow-up visit. Conclusion Intravitreous injection of Lucentis combined with trabeculectomy and MMC application could effectively control the IOP and pteserve the visual function in patients with neovascular glaucoma.