玻璃体腔注射康柏西普联合小梁切除术及全视网膜光凝治疗新生血管性青光眼

目的：探究玻璃体腔注射康柏西普联合手术及全视网膜光凝治疗新生血管性青光眼(neovascular glaucoma，NVG)的临床疗效。

方法：本组探究对象选择2014-06/2016-06于我院治疗的新生血管性青光眼患者90例，对所有患者的病历资料进行回顾性分析，将采用小梁切除术及全视网膜光凝治疗的42例患者设为对照组，在此基础上术前5～7d加用玻璃体腔注射康柏西普的48例患者设为观察组。比较两组患者治疗前、治疗后1wk，1、3、6mo最佳矫正视力(转换成标准对数视力)，各时期通过非接触式眼压计测量眼压，采用前房角镜检查虹膜及房角新生血管消退情况，结合眼压等判断综合疗效，记录术后并发症发生情况。

结果：两组治疗前后视力比较差异显著，组间比较观察组术后1mo显著高于对照组，差异有统计学意义(P<0.05)，术后1wk，3、6mo无显著性差异(P>0.05)； 两组治疗前后眼压比较差异显著，组间比较观察组术后1wk，1、3、6mo显著低于对照组，差异有统计学意义(P<0.05)； 观察组综合治愈率为77%，显著高于对照组(64%)，差异有统计学意义(P<0.05)； 观察组前房出血、浅前房发生率显著低于对照组，差异有统计学意义(P<0.05)； 低眼压黄斑性病变发生率无显著性差异(P>0.05)； 观察组术后6mo新生血管复发率显著低于对照组，差异有统计学意义(P<0.05)。

结论：新生血管性青光眼在全视网膜光凝治疗术前5～7d加用玻璃体腔注射康柏西普能显著降低眼压，不同程度改善视力，综合治愈率更高。

Intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma

AIM: To investigate the clinical efficacy of intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma(NVG).

METHODS: The clinical data of 90 patients with NVG treated in our hospital from June 2014 to June 2016 were analyzed retrospectively. There were 42 patients treated with trabeculectomy and panretinal photocoagulation enrolled as the control group. On the basis of this, 48 patients who received intravitreal injection of conbercept 5-7d preoperatively were enrolled as observation group. The best corrected visual acuity(standard logarithmic visual acuity), intraocular pressure and the regression of neovascularization were observed and compared before treatment, and 1wk, 1, 3, and 6mo post treatment. Then the clinical efficacy and postoperative complications were observed and recorded.

RESULTS: The difference of visual acuity of the two groups was significant before and after treatment, and the best corrected visual acuity of observation group was significantly higher than that of the control group at 1mo after the operation(P<0.05), no difference was found at 1wk, 3 and 6mo post treatment(P>0.05). The pre- and postoperative intraocular pressure of the two groups showed significant difference, and the intraocular pressure of the observation group was significantly lower than the control group at 1wk, 1, 3 and 6mo post treatment(P<0.05). The cure rate in the observation group was significantly higher than that in the control group(77% vs 64%), with statistical significance(P<0.05). The incidence of anterior chamber hemorrhage and shallow anterior chamber in the observation group was significantly lower than that of the control group(P<0.05), with no difference in the incidence of macular degeneration(P>0.05). Moreover, the recurrence rate of neovascularization in the observation group was significantly lower than that of the control group at 6mo after operation(P<0.05).

CONCLUSION: The intravitreal injection of conbercept 5-7d before panretinal photocoagulation can significantly reduce intraocular pressure, improve the visual acuity for the treatment of NVG, which also has a higher comprehensive cure rate.