玻璃体腔注射康柏西普联合复合式小梁切除术治疗新生血管性青光眼患者
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摘要
目的:探讨玻璃体腔注射康柏西普联合复合式小梁切除术对治疗新生血管性青光眼患者的疗效和安全性。方法:选取新生血管性青光眼患者34例(34眼),随机分为研究组和对照组,每组各17例。研究组患者行玻璃体腔注射康柏西普0.05 mg联合复合式小梁切除术及视网膜激光光凝补充治疗;对照组患者行常规复合式小梁切除术。术后随访6个月,观察研究组患者玻璃体腔注射康柏西普后,虹膜及前房角新生血管消退时间,注药后眼压、晶状体改变,以及两组患者复合式小梁切除术后视力、眼压、前房、前房积血、前房渗出和滤过泡情况。结果:玻璃体腔注药后,两组患者5~10 d虹膜新生血管完全消退;复合式小梁切除术后,两组患者的眼压、前房、滤过泡差异明显(P<0.05);术后随访6个月研究组患者的4例眼视力有不同程度提高,13例眼视力与术前无差异。结论:玻璃体内注射康柏西普联合复合式小梁切除术及视网膜激光光凝补充治疗,能有效治疗新生血管性青光眼患者,可使其虹膜新生血管快速消退或萎缩,降低术后前房积血的发生率、提高手术成功率。
Objective: To investigate therapeutic efficacy and safety of intravitreal injection of Conbercept combined with compound trabeculectomy in treatment of neovascular glaucoma. Methods: 34 patients( 34 eyes) with neovascular glaucoma were selected and randomly divided into two groups: 17 eyes of experimental group and 17 eyes of control group. The experimental group was injected with Conbercept0.05 mg in vitreous cavity before the compound trabeculectomy operation,and then was given laser photocoagulation treatment for iris neovascularization under the local anesthesia,while the control group undergone routine trabeculectomy. Postoperatively,all the patients received follow-up of 6 months. The disappearing time of new blood vessels in iris and anterior chamber angle,intraocular pressure,and lens changes after intravitreal injection of Conbercept as well as visual acuity,intraocular pressure,anterior chamber,hyphema,anterior chamber exudation,filtrating bleb conditions after compound trabeculectomy were observed. Results: After intravitreal injection of Conbercept,the new blood vessels in iris of the two groups completely disappeared in 5-10 days.After compound trabeculectomy,the differences in the intraocular pressure,anterior chamber and filtering bleb of two groups were statistically significant( P<0.05). The 6-month postoperative follow-up showed that the visual acuity of 4 eyesin the experimental group improved in a different degree,but those of 13 eyes had no difference. Conclusions: Intravitreal injection of Conberceptcombined with trabeculectomy surgery and retinal photocoagulation therapy can effectively treat neovascular glaucoma,and make iris neovascularization quickly fade or shrink,reduce the incidence of postoperative hyphema,and improve the success rate of operation.
Objective: To investigate therapeutic efficacy and safety of intravitreal injection of Conbercept combined with compound trabeculectomy in treatment of neovascular glaucoma. Methods: 34 patients( 34 eyes) with neovascular glaucoma were selected and randomly divided into two groups: 17 eyes of experimental group and 17 eyes of control group. The experimental group was injected with Conbercept0.05 mg in vitreous cavity before the compound trabeculectomy operation,and then was given laser photocoagulation treatment for iris neovascularization under the local anesthesia,while the control group undergone routine trabeculectomy. Postoperatively,all the patients received follow-up of 6 months. The disappearing time of new blood vessels in iris and anterior chamber angle,intraocular pressure,and lens changes after intravitreal injection of Conbercept as well as visual acuity,intraocular pressure,anterior chamber,hyphema,anterior chamber exudation,filtrating bleb conditions after compound trabeculectomy were observed. Results: After intravitreal injection of Conbercept,the new blood vessels in iris of the two groups completely disappeared in 5-10 days.After compound trabeculectomy,the differences in the intraocular pressure,anterior chamber and filtering bleb of two groups were statistically significant( P<0.05). The 6-month postoperative follow-up showed that the visual acuity of 4 eyesin the experimental group improved in a different degree,but those of 13 eyes had no difference. Conclusions: Intravitreal injection of Conberceptcombined with trabeculectomy surgery and retinal photocoagulation therapy can effectively treat neovascular glaucoma,and make iris neovascularization quickly fade or shrink,reduce the incidence of postoperative hyphema,and improve the success rate of operation.
引文
[1]龚玉静,郝燕燕.睫状体光凝联合玻璃体腔内注射Avastin治疗新生血管性青光眼的临床观察[J].郑州大学学报:医学版,2011,46(6):937.
[2]Li X,Xu G,Wang Y,et a1.Safety and efficacy of conbercept in neovascular age-related macular degeneration:results from a 12-month randomized phase 2 study:AURORA study[J].Ophthalmology,2014,121(9):1740-1747.
[3]吕明,孔凡宏,刘建华,等.复合式小梁切除术与传统小梁切除术治疗原发性闭角型青光眼的临床观察[J].国际眼科杂志,2009,9(11):2100-2101.
[4]盛敏杰,林安娟,屈晨.晶状体后囊膜前纤维机化膜摘除术[J].实用眼科学杂志,2007,25(3):274-276.
[5]Van Buskirk EM.Cysts of Tenon's capsule following filtration surgery[J].Am J Ophthalmol,1982,94(5):522-527.
[6]赵家良.眼科疾病临床诊疗规范教程[M].北京:北京大学医学出版社,2007:166.
[7]陶绍武,李惠,李静,等.新生血管性青光眼治疗时机的临床研究[J].国际眼科杂志,2013,13(3):519-521.
[8]Sasamoto Y,Oshima Y,Miki A,et a1.Clinical outcomes and changes in aqueous vascular endothelial growth facfor levels after intravitreal bevacizumab for iris neovascularization and neovascular glaucoma:a retrospective two-dose comparative study[J].J Ocul Pharmacol Ther,2012,28(1):41.
[9]Chang JH,Garg NK,Lunde E,et a1.Corneal neovascularization:an anti-VEGF therapy review[J].Surv Ophthalmol,2012.57(5):415.
[10]J Park HY,Kim JH,Park CK.VEGF induces TGF-β1 expression and myofibroblast transformation after glaucoma surgery[J].Am J Pathol,2013,182(6):2147-2154.
[11]钟华,袁援生,赵灿,等.Bevacizumab联合Ex-press引流管治疗新生血管性青光眼[J].国际眼科杂志,2013,13(12):2443-2445.
[2]Li X,Xu G,Wang Y,et a1.Safety and efficacy of conbercept in neovascular age-related macular degeneration:results from a 12-month randomized phase 2 study:AURORA study[J].Ophthalmology,2014,121(9):1740-1747.
[3]吕明,孔凡宏,刘建华,等.复合式小梁切除术与传统小梁切除术治疗原发性闭角型青光眼的临床观察[J].国际眼科杂志,2009,9(11):2100-2101.
[4]盛敏杰,林安娟,屈晨.晶状体后囊膜前纤维机化膜摘除术[J].实用眼科学杂志,2007,25(3):274-276.
[5]Van Buskirk EM.Cysts of Tenon's capsule following filtration surgery[J].Am J Ophthalmol,1982,94(5):522-527.
[6]赵家良.眼科疾病临床诊疗规范教程[M].北京:北京大学医学出版社,2007:166.
[7]陶绍武,李惠,李静,等.新生血管性青光眼治疗时机的临床研究[J].国际眼科杂志,2013,13(3):519-521.
[8]Sasamoto Y,Oshima Y,Miki A,et a1.Clinical outcomes and changes in aqueous vascular endothelial growth facfor levels after intravitreal bevacizumab for iris neovascularization and neovascular glaucoma:a retrospective two-dose comparative study[J].J Ocul Pharmacol Ther,2012,28(1):41.
[9]Chang JH,Garg NK,Lunde E,et a1.Corneal neovascularization:an anti-VEGF therapy review[J].Surv Ophthalmol,2012.57(5):415.
[10]J Park HY,Kim JH,Park CK.VEGF induces TGF-β1 expression and myofibroblast transformation after glaucoma surgery[J].Am J Pathol,2013,182(6):2147-2154.
[11]钟华,袁援生,赵灿,等.Bevacizumab联合Ex-press引流管治疗新生血管性青光眼[J].国际眼科杂志,2013,13(12):2443-2445.