CAJ | 학술논문

目的：评价Ahmed青光眼引流阀植入联合全视网膜光凝和玻璃体腔注射Avastin治疗新生血管性青光眼的临床疗效。方法回顾性分析我院2011年6月～2012年5月收治住院行Ahmed青光眼引流阀植入术联合全视网膜光凝和玻璃体腔注射Avastin治疗的20例（20只眼）新生血管性青光眼患者的临床资料。主要观察指标为手术前后视力、眼压、虹膜新生血管消退情况、并发症及手术成功率等，术后随访12～18个月。结果全视网膜光凝和玻璃体腔注射avastin后1周内20眼虹膜新生血管均不同程度消退。术后最后一次随访发现，20眼中仅有3眼联合抗青光眼药物眼压≤21mmHg，其余17眼术后眼压控制在正常范围，手术成功率达到85％．最后一次随访，平均眼压（15．31±4．27）mmHg，与术前平均眼压（49．03±12．87）mmHg比较，差异有统计学意义（P＝0．000）。视力提高者8眼（40％），保持不变者10眼，下降2眼。术后并发症主要是早期的短暂性浅前房、高眼压及晚期的滤过道瘢痕纤维化。结论 Ahmed引流阀植入联合全视网膜光凝和玻璃体腔注射Avastin治疗新生血管性青光眼安全有效，有利于保护残留的视功能，手术成功率高，并发症少，可以作为新生血管性青光眼患者的首选手术方式之一。
목적：평개Ahmed청광안인류벌식입연합전시망막광응화파리체강주사Avastin치료신생혈관성청광안적림상료효。방법회고성분석아원2011년6월～2012년5월수치주원행Ahmed청광안인류벌식입술연합전시망막광응화파리체강주사Avastin치료적20례（20지안）신생혈관성청광안환자적림상자료。주요관찰지표위수술전후시력、안압、홍막신생혈관소퇴정황、병발증급수술성공솔등，술후수방12～18개월。결과전시망막광응화파리체강주사avastin후1주내20안홍막신생혈관균불동정도소퇴。술후최후일차수방발현，20안중부유3안연합항청광안약물안압≤21mmHg，기여17안술후안압공제재정상범위，수술성공솔체도85％．최후일차수방，평균안압（15．31±4．27）mmHg，여술전평균안압（49．03±12．87）mmHg비교，차이유통계학의의（P＝0．000）。시력제고자8안（40％），보지불변자10안，하강2안。술후병발증주요시조기적단잠성천전방、고안압급만기적려과도반흔섬유화。결론 Ahmed인류벌식입연합전시망막광응화파리체강주사Avastin치료신생혈관성청광안안전유효，유리우보호잔류적시공능，수술성공솔고，병발증소，가이작위신생혈관성청광안환자적수선수술방식지일。
Objective To evaluate the effect of Ahmed glaucoma drainage valve implantation combined with panretinal photoco -agulation and intravitreal Avastin in the treatment of neovascular glaucoma .Methods Clinical data of 20 patients with neovascular glaucoma (20 eyes) treated with Ahmed glaucoma drainage valve implantation combined with panretinal photocoagulation and intravitreal Avastin from June 2011 to May 2012 in our hospital were retrospectively analyzed .Cases were followed up for 12~18 months with observation on visual a-cuity,IOP control,regression of iris neovessels ,complications and success rate after surgery .Results Iris neovessels regressed in all cases at different degree within 1 week after panretinal photocoagulation and intravitreal Avastin .At final follow-up,the IOP of 17 eyes were all less than 21mmHg without any drugs and of 3 eyes with anti-glaucoma drugs after surgery .The mean IOP dropped from (49.03 ±12.87) mmHg preoperatively to (15.31 ±4.27)mmHg postoperatively.IOP reduction was statistically different between preoperative and postoperative (P=0.000) at final follow-up.The postoperative best corrected visual acuity improved in 8 cases(40%),stable in 10 cases and dropped in 2 eyes.The common postoperative complications included transient flat anterior chamber ,high intraocular pressure in early stage and filtration tissue fibrosis in late stage .Conclusion Ahmed glaucoma drainage valve implantation combined with panretinal photocoagulation and intrav -itreal Avastin is safe and effective in the treatment of neovascular glaucoma .It improves the success rate of surgery and preserves resident vis-ual function with less complications .So the surgery style can be used as one of the preferred treatment methods .