中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2015年
2期
86-89
,共4页
青光眼,新生血管性%玻璃体积血%雷珠单抗(Lucentis)%玻璃体内注射%玻璃体切除术
青光眼,新生血管性%玻璃體積血%雷珠單抗(Lucentis)%玻璃體內註射%玻璃體切除術
청광안,신생혈관성%파리체적혈%뢰주단항(Lucentis)%파리체내주사%파리체절제술
Glaucoma,neovascular%Hemorrhage,vitreous%Lucentis%Injection,intravitreal%Vitrectomy
目的 观察联合手术治疗伴玻璃体积血的新生血管性青光眼的临床疗效.方法 伴玻璃体积血的新生血管性青光眼26例(26只眼),年龄36 ～ 63岁,平均(51.97 ±7.60)岁.治疗前logMAR最佳矫正视力平均为(2.62±0.43),眼压平均为(46.38 ±6.75) mmHg(1 mm Hg =0.133kPa),虹膜及前房角广泛新生血管,玻璃体积血,眼底不能清楚视及.26只眼均行雷珠单抗(Lucen-tis)0.5 mg(0.05 ml)玻璃体内注射,注射后5～7d行玻璃体切除联合晶状体切除、广泛视网膜光凝及小梁切除术.结果 随访6 ～ 12个月,平均(8.69±2.56)月.26只眼的logMAR最佳矫正视力平均为(1.26±0.36),较治疗前高(t=6.13,P=0.00),其中,22只眼视力有不同程度的提高(84.62％),4只眼视力无明显变化(15.38％),未见术后视力下降的情况.26只眼的平均眼压为(18.65±0.56) mmHg,较治疗前低(t=6.61,P=0.00).26只眼虹膜及前房角的新生血管于雷珠单杭玻璃体内注射后1周内完全或部分消退.治疗过程中未发现严重的眼部或全身并发症.结论 对于伴玻璃体积血的新生血管性青光眼,行雷珠单抗玻璃体内注射联合玻璃体切除、晶状体切除、广泛视网膜光凝及小梁切除术,能促使新生血管消退,有效控制眼压,一定程度上提高患者的视力,未发现严重并发症.
目的 觀察聯閤手術治療伴玻璃體積血的新生血管性青光眼的臨床療效.方法 伴玻璃體積血的新生血管性青光眼26例(26隻眼),年齡36 ～ 63歲,平均(51.97 ±7.60)歲.治療前logMAR最佳矯正視力平均為(2.62±0.43),眼壓平均為(46.38 ±6.75) mmHg(1 mm Hg =0.133kPa),虹膜及前房角廣汎新生血管,玻璃體積血,眼底不能清楚視及.26隻眼均行雷珠單抗(Lucen-tis)0.5 mg(0.05 ml)玻璃體內註射,註射後5～7d行玻璃體切除聯閤晶狀體切除、廣汎視網膜光凝及小樑切除術.結果 隨訪6 ～ 12箇月,平均(8.69±2.56)月.26隻眼的logMAR最佳矯正視力平均為(1.26±0.36),較治療前高(t=6.13,P=0.00),其中,22隻眼視力有不同程度的提高(84.62％),4隻眼視力無明顯變化(15.38％),未見術後視力下降的情況.26隻眼的平均眼壓為(18.65±0.56) mmHg,較治療前低(t=6.61,P=0.00).26隻眼虹膜及前房角的新生血管于雷珠單杭玻璃體內註射後1週內完全或部分消退.治療過程中未髮現嚴重的眼部或全身併髮癥.結論 對于伴玻璃體積血的新生血管性青光眼,行雷珠單抗玻璃體內註射聯閤玻璃體切除、晶狀體切除、廣汎視網膜光凝及小樑切除術,能促使新生血管消退,有效控製眼壓,一定程度上提高患者的視力,未髮現嚴重併髮癥.
목적 관찰연합수술치료반파리체적혈적신생혈관성청광안적림상료효.방법 반파리체적혈적신생혈관성청광안26례(26지안),년령36 ～ 63세,평균(51.97 ±7.60)세.치료전logMAR최가교정시력평균위(2.62±0.43),안압평균위(46.38 ±6.75) mmHg(1 mm Hg =0.133kPa),홍막급전방각엄범신생혈관,파리체적혈,안저불능청초시급.26지안균행뢰주단항(Lucen-tis)0.5 mg(0.05 ml)파리체내주사,주사후5～7d행파리체절제연합정상체절제、엄범시망막광응급소량절제술.결과 수방6 ～ 12개월,평균(8.69±2.56)월.26지안적logMAR최가교정시력평균위(1.26±0.36),교치료전고(t=6.13,P=0.00),기중,22지안시력유불동정도적제고(84.62％),4지안시력무명현변화(15.38％),미견술후시력하강적정황.26지안적평균안압위(18.65±0.56) mmHg,교치료전저(t=6.61,P=0.00).26지안홍막급전방각적신생혈관우뢰주단항파리체내주사후1주내완전혹부분소퇴.치료과정중미발현엄중적안부혹전신병발증.결론 대우반파리체적혈적신생혈관성청광안,행뢰주단항파리체내주사연합파리체절제、정상체절제、엄범시망막광응급소량절제술,능촉사신생혈관소퇴,유효공제안압,일정정도상제고환자적시력,미발현엄중병발증.
Objective To observe the effects of combined surgery for neovascular glaucoma (NVG) with vitreous hemorrhage.Methods Twenty-six eyes of 26 patients of NVG with vitreous hemorrhage underwent intravitreal injection of 0.5mg (0.05ml) Lucentis combined with vitrectomy,lensectomy,panretinal photocoagulation and trabeculectomy.The patients aged from 36 to 63 years old with average age of (51.97 ± 7.60) years old.The best corrected visual acuity (BCVA) of log MAR was (2.62 ± 0.43) and the intraocular pressure (IOP) was (46.38 ± 6.75) mmHg (1 mm Hg =0.133 kPa).Results The follow-up period ranged from 6 to 12 months with average (8.69 ± 2.56) months.The mean postoperative log MAR BCVA of 26 eyes was significantly improved as (1.26 ± 0.36),and the difference was statistically significant compared with that before treatment (t=6.13,P =0.00).The log MAR BCVA improved in 22 eyes (84.62％),and remained stable in 4 eyes (15.38％).The mean postoperative IOP was (18.65 ± 0.56) mmHg which was significantly lower than preoperative one (t =6.61,P =0.00).The neovascularization of iris and anterior chamber angle in all patients completely or partly disappeared one week after Lucentis injection.No serious complication occurred.Conclusion Intravitreal injection of Lucentis combined with vitrectomy,Lensectomy,panretinal photocoagulation,and trabeculectomy can control IOP well and improve BCVA without severe complication for NVG patients with vitreous hemorrhage.
