雷珠单抗辅助玻璃体切割和PRP联合小梁切除术治疗NVG的疗效

目的：观察雷珠单抗辅助玻璃体切割+全视网膜光凝(PRP)+小梁切除术治疗新生血管性青光眼(NVG)的临床疗效。

方法：回顾性分析2017-03/2018-10收治的NVG患者44例44眼，采用玻璃体腔内注射雷珠单抗+玻璃体切割+PRP+小梁切除手术治疗的患者22例22眼(A组)，采用玻璃体腔内注射雷珠单抗+小梁切除+PRP治疗的患者22例22眼(B组)。术后随访6mo，观察患者视力、眼压、眼压控制率、新生血管及并发症等情况。

结果：治疗前两组患者眼压无差异(46.2±9.41mmHg vs 49.1±10.15mmHg，P>0.05)，治疗后1wk，1、6mo A组患者眼压均低于B组(P<0.05)。治疗后6mo，A组视力、眼压控制率(95%)、新生血管消退情况(91%)均优于B组(P<0.05)，但随访期间两组患者并发症发生率无差异(P>0.05)。

结论：雷珠单抗辅助玻璃体切割+PRP+小梁切除术治疗NVG安全有效，可稳定持久地控制眼压，改善部分患者视力。

Clinical observation on the treatment of neovascular glaucoma with intravitreal Ranibizumab injection combined with vitrectomy, panretinal photocoagulation and trabeculectomy

AIM: To observe the clinical effect of ranibizumab injection combined with vitrectomy,panretinal photocoagulation(PRP)and trabeculectomy in the treatment of neovascular glaucoma(NVG).

METHODS: Retrospective study. From March 2017 to October 2018, 44 NVG patients(44 eyes)were treated, 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + vitrectomy + PRP+trabeculectomy(group A), and 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + trabeculectomy+PRP(group B).The patients were followed up for 6mo, the visual acuity, intraocular pressure(IOP), IOP control rate, neovascularization and complications were observed.

RESULTS: There was no significant difference in IOP between the two groups before treatment(46.2±9.41mmHg vs 49.1±10.15mmHg, P>0.05). The IOP of group A was lower than that of group B at 1wk, 1mo and 6mo after treatment(P<0.05). 6mo after treatment, the visual acuity, IOP control rate(95%)and neovascularization regression(91%)in group A were better than those in group B(P<0.05), but there was no difference in the incidence of complications between the two groups during the follow-up period(P>0.05).

CONCLUSION: It is safe and effective to treat NVG with intravitreal ranibizumab injection combined with vitrectomy, PRP and trabeculectomy, which can control IOP steadily and improve visual acuity of some patients.