雷珠单抗联合Ahmed青光眼阀植入术治疗新生血管性青光眼

目的　观察玻璃体腔注射雷珠单抗联合Ａｈｍｅｄ青光眼阀植入术对新生血管性青光眼的治疗效果。方法　选择药物无法控制眼压的新生血管性青光眼患者１８例１８眼，先给予患眼玻璃体腔注射雷珠单抗０．０５ｍＬ，于注药１周后行Ａｈｍｅｄ青光眼阀植入术，并于术后及时行眼底荧光血管造影及视网膜激光光凝术。结果　注药后２～７ｄ，１６眼新生血管全部消退，２眼残留少许血管。玻璃体腔注药前眼压为３８．０～５９．０（４８．５±９．５）ｍｍ-Ｈｇ（１ｋＰａ＝７．５ｍｍＨｇ），注药后１周眼压为３６．５～５９．０（４７．８±１１．３）ｍｍＨｇ，注药前后眼压变化差异无统计学意义（Ｐ＞０．０５）。青光眼阀植入术后随访１ａ，１４例患者眼压控制在正常范围，４例患者眼压出现不同程度升高。青光眼阀植入术前后眼压变化差异有统计学意义（Ｐ＜０.０１）。青光眼阀植入术后视力提高者８例，视力无明显变化者１０例。结论　玻璃体腔注射雷珠单抗联合Ａｈｍｅｄ青光眼阀植入术治疗新生血管性青光眼安全有效。

Intravitreal lucentis injection combined with Ahmed valve implantation for neovascular glaucoma

Objective To evaluate the clinical therapeutic efficacy of intravitreal lucentis injection combined with Ahmed valve implantation for neovascular glaucoma ( NVG) . Methods Eighteen confirmed cases ( 18 eyes) with NVG . whose IOP could not be controlled by antiglaucoma medication .were received intravitreal injection of lucentis . after I week the Ahmed valve implantation were performed. Then the FFA and the retinal laser photocoagulation treatment were taken. Results The iris neovessels were regressed in 16 cases from 2 days t0 7 days after the intravitreal injection of lucentis , and 2 cases remained a few fine neovessels. The intraocular pressure ( IOP) before injection was 38. 0 - 59. 0 ( 48. 5 +9. 5 ) mmHg ( I kPa = 7. 5 mmHg) ,1 week after injection was 36. 5 - 59. 0 ( 47. 8 + 11. 3 ) mmHg , there was no statistical difference ( P > 0. 05 ) . After a follow-up of one year,IOP in 14 cases were controlled in normal.4 cases were increased. There was sigruficant difference in IOP before and after Ahmed valve implantation ( P < 0. 01 ) . The visual acuity in 8 cases were increased after Ahmed valve implantation.unchanged in 10 cases. Conclusion The intravitreal lucentis injection combined with Ahmed valve implantation for NVG is safe and effective.