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

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3~7 d行玻璃体腔注射雷珠单抗（10 g·L^-1）或者康柏西普（10 g·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（P<0.01）；3组患者术后平均抗青光眼药物数目均较术前明显减少（P<0.01）；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（P>0.05）；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（P<0.05）；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（P>0.05）。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。

Efficacy of intravitreal lucentis or conbercept injection combined with ahmed glaucoma valve implantation for treatment of neovascular glaucoma

Objective:To evaluate the efficacy of intravitreal lucentis or conbercept injection combined with ahmed glaucoma valve (AGV)implantation on the treatment of neovascular glaucoma (NVG).Methods:A total of 68 NVG patients (68 eyes)were divided into three groups according to the pretreatment (the intravitreal injection of lucentis or conbercept or no intravitreal injection 3 - 7 d before AGV implantation):lucentis group (n = 26, given intravitreal injection of 10 g · L-1 lucentis),conbercept group (n = 21, given intravitreal injection of 10 g·L-1 conbercept)and control group (n=21,given medicine or puncture of anterior chamber to smoothen the IOP and received AGV implantation).The panretina photocoagnlation (PRP)was performed in the patients with clear ocular media before intravitreal injection or AGV implantation.For the patients with cloudy ocular media,the intravitreal injection of anti-VEGF drugs was performed first and the PRP was performed when fundus could be seen.Results:Compared with before operation,the mean IOP and the number of antiglaucoma medications of the patients used in three groups after operation were significantly decreased (P < 0.01).There were no significant differences in the successful rates of operation of the patients in three groups at different time points after operation (P >0.05).1 month and 3 months after operation,the BCVA of the patients in lucentis and conbercept groups was significantly better than that in control group (P <0.05).There were no significant differences in the incidence of complications of the pateints between lucentis and conbercept groups at different time points after operation (P >0.05).Conclusion:Intravitreal injection of anti-VEGF drugs combined with AGV implantation is effective and safe in the treatment of NVG.In short term,it can improve the vision,relieve the pain and reduce the complications.