抗VEGF综合治疗对新生血管性青光眼的疗效

目的:观察联合抗VEGF药物的综合治疗对新生血管性青光眼(NVG)的疗效。方法:回顾性分析2012-02/2018-10在我院就诊的NVG患者62例68眼的临床资料,A组先行玻璃体腔注射抗VEGF药物,术后1wk行复合式小梁切除术,术后3wk行全视网膜激光;B组行睫状体冷凝术。观察两组患者治疗前和治疗后2wk,1、3、6mo的眼压、最佳矫正视力(BCVA)、眼轴和并发症等。结果:A组虹膜新生血管的消退程度优于B组。两组患者术后2wk,1、3、6mo眼压比较有差异(P<0.05),且治疗后6mo眼轴长度有差异(P<0.05)。A组总有效率为94%,B组总有效率为78%(P=0.073)。结论:NVG接受抗VEGF药物+复合式小梁切除术+全视网膜激光光凝治疗安全有效。

Observation on the curative effect of anti-VEGF comprehensive treatment for neovascular glaucoma

AIM: To observe the effects of combined anti-VEGF therapy on neovascular glaucoma.

METHODS: A total of 62 patients(68 eyes)with neovascular glaucoma admitted to our hospital from February 2012 to October 2018 were retrospectively analyzed. Group A were given intravitreal injection of anti-VEGF drug(conbercept ophthalmic injection)0.05mL, and complex trabeculectomy was performed 1wk after injection, and total retinal laser photocoagulation was performed 3wk after injection. Cyclocryosurgery was performed in group B. Intraocular pressure(IOP), best corrected visual acuity(BCVA), axial length and postoperative complications of patients in two groups were observed before treatment and 2wk, 1mo, 3mo and 6mo after treatment.

RESULTS: The regression degree of iris neocescularization in group A was significantly better than that in group B. IOP at 2wk, 1mo, 3mo and 6mo after surgery in the two groups showed statistical differences(P<0.05). There was a statistically significant difference in axial length 6mo after treatment(P<0.05). The total effective rate was 94% in anti-VEGF group(group A)and 78% in cyclocryosurgery group(group B), the difference was not statistically significant(P=0.073).

CONCLUSION: It is safe and effective for the combined treatment of anti-VEGF drug, combined trabeculectomy and total retinal laser photocoagulation in the treatment of neovascularization glaucoma.