中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
12期
1272-1274
,共3页
Bevicazumab%玻璃体切割术%睫状体光凝%新生血管性青光眼%玻璃体积血
Bevicazumab%玻璃體切割術%睫狀體光凝%新生血管性青光眼%玻璃體積血
Bevicazumab%파리체절할술%첩상체광응%신생혈관성청광안%파리체적혈
Bevacizumab%Vitrectomy%Neovascular glaucoma%Cyclophotoeoagulation%Vitreous hemorrhage
目的 探讨玻璃体腔注射bevacizumab (IVB)联合玻璃体切除、全视网膜光凝和睫状体光凝治疗新生血管性青光眼( neovascular glaucoma,NVG)的效果.方法 21例患者21只眼因伴玻璃体积血新生血管性青光眼接受玻璃体腔注射Bevacizuma 0.05 mL/1.25 mg,治疗后第8天进行玻璃体切除、视网膜光凝+睫状体光凝.术后随访12个月(8～15个月),观察手术前后视力、眼压、虹膜及房角新生血管情况.结果 12只眼于IVB 3 d后虹膜表面、房角新生血管完全消失,5只眼于7d后虹膜表面、房角新生血管完全消失,4只眼7d后新生血管部分消失.IVB治疗前平均眼压(46.8±6.35 )mm Hg,治疗后7d平均眼压(35.07±5.28)mm Hg,两者眼压比较虽然差异有显著性(P＜0.01).行玻璃体切除、视网膜光凝+睫状体光凝术后1周,1、6、12月平均眼压分别(26.85±5.16；21.70±2.41；15.34±4.42；19.21±5.13) mmHg,与手术前平均眼压比较差异均有显著性(P＜0.01).手术完全成功11只眼(52％),部分成功6只眼(29％),失败4只眼(19％).17只眼视力保持稳定或稍有增进(HM-0.05).结论 玻璃体内注射Bevacizumab后行玻璃体切除联合视网膜及睫状体光凝治疗,可以促进虹膜、房角、视网膜新生血管迅速消退,降低手术并发症,有效控制眼压,是治疗伴玻璃体积血的新生血管性青光眼的有效方法.
目的 探討玻璃體腔註射bevacizumab (IVB)聯閤玻璃體切除、全視網膜光凝和睫狀體光凝治療新生血管性青光眼( neovascular glaucoma,NVG)的效果.方法 21例患者21隻眼因伴玻璃體積血新生血管性青光眼接受玻璃體腔註射Bevacizuma 0.05 mL/1.25 mg,治療後第8天進行玻璃體切除、視網膜光凝+睫狀體光凝.術後隨訪12箇月(8～15箇月),觀察手術前後視力、眼壓、虹膜及房角新生血管情況.結果 12隻眼于IVB 3 d後虹膜錶麵、房角新生血管完全消失,5隻眼于7d後虹膜錶麵、房角新生血管完全消失,4隻眼7d後新生血管部分消失.IVB治療前平均眼壓(46.8±6.35 )mm Hg,治療後7d平均眼壓(35.07±5.28)mm Hg,兩者眼壓比較雖然差異有顯著性(P＜0.01).行玻璃體切除、視網膜光凝+睫狀體光凝術後1週,1、6、12月平均眼壓分彆(26.85±5.16；21.70±2.41；15.34±4.42；19.21±5.13) mmHg,與手術前平均眼壓比較差異均有顯著性(P＜0.01).手術完全成功11隻眼(52％),部分成功6隻眼(29％),失敗4隻眼(19％).17隻眼視力保持穩定或稍有增進(HM-0.05).結論 玻璃體內註射Bevacizumab後行玻璃體切除聯閤視網膜及睫狀體光凝治療,可以促進虹膜、房角、視網膜新生血管迅速消退,降低手術併髮癥,有效控製眼壓,是治療伴玻璃體積血的新生血管性青光眼的有效方法.
목적 탐토파리체강주사bevacizumab (IVB)연합파리체절제、전시망막광응화첩상체광응치료신생혈관성청광안( neovascular glaucoma,NVG)적효과.방법 21례환자21지안인반파리체적혈신생혈관성청광안접수파리체강주사Bevacizuma 0.05 mL/1.25 mg,치료후제8천진행파리체절제、시망막광응+첩상체광응.술후수방12개월(8～15개월),관찰수술전후시력、안압、홍막급방각신생혈관정황.결과 12지안우IVB 3 d후홍막표면、방각신생혈관완전소실,5지안우7d후홍막표면、방각신생혈관완전소실,4지안7d후신생혈관부분소실.IVB치료전평균안압(46.8±6.35 )mm Hg,치료후7d평균안압(35.07±5.28)mm Hg,량자안압비교수연차이유현저성(P＜0.01).행파리체절제、시망막광응+첩상체광응술후1주,1、6、12월평균안압분별(26.85±5.16；21.70±2.41；15.34±4.42；19.21±5.13) mmHg,여수술전평균안압비교차이균유현저성(P＜0.01).수술완전성공11지안(52％),부분성공6지안(29％),실패4지안(19％).17지안시력보지은정혹초유증진(HM-0.05).결론 파리체내주사Bevacizumab후행파리체절제연합시망막급첩상체광응치료,가이촉진홍막、방각、시망막신생혈관신속소퇴,강저수술병발증,유효공제안압,시치료반파리체적혈적신생혈관성청광안적유효방법.
Objective To investigate the clinical efficacy of adjunctive intravitreal Bevacizumab (avastin) combined with vitrectomy,panretinal photocoagulation and cyclophotocoagulation for neovascular glaucoma to accompany with vitreous hemorrhage.Methods A total of 21 NVG patients (21eyes) who were suffering from neovascular glaucoma to accompany with vitreous hemorrhage were taken treatment in our hospital from August 2007 to May 2010.All eyes accepted the vitrectomy combined with panretinal photocoagulation and cyclophotocoagulation 7 days after IVB (0.05 mL/1.25mg).The condition of the new vessels on the angle of anterior chamber and iris,the intraocular pressure and the visual acuity were observed postoperatively.The mean follow-up was 12 months (8～15months).Results In 12 eyes,the angle of anterior chamber and the iris neovascularization regressed completely within 3 days.In 5 eyes,it's within 7 days.Another 4 eyes,neovascularization regressed partly.The mean IOP level was (46.80 ± 6.35mmHg) before the IVB and (35.07± 5.28mmHg) before operation,which had significant difference (P ＜0.01).The mean IOP level of 1 week and 1 month,6and 12 months after the vitrectomy combined with panretinal photocoagulation and cyclophotocoagulation were (26.85± 5.16; 21.70± 2.41; 15.34± 4.42; 19.21± 5.13) mmHg respectively which were significant different from the mean IOP level preoperative (P ＜0.01).The IOP were controlled completely in 11 eyes (52％),partly controlled in 6 eyes (29％),and not controlled in 4 eyes (19％).The visual acuity of 17 eyes was stable or rise slightly.Conclusions Adjunctive intravitreal Bevacizumab Combined with vitrectomy,panretinal photocoagulation and cyclophotocoagulation is effective therapy with high achievement rate,low incidence of complications for neovascular glaucoma to accompany with vitreous hemorrhage.
