中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
4期
370-373
,共4页
王华%王涛%张风%左华欣
王華%王濤%張風%左華訢
왕화%왕도%장풍%좌화흔
小梁切除术%Ranibizumab%新生血管性青光眼
小樑切除術%Ranibizumab%新生血管性青光眼
소량절제술%Ranibizumab%신생혈관성청광안
Trabeculectomy%Ranibizumab%Neovascular glaucoma
目的 观察玻璃体腔内注射雷珠单抗(Lucentis)后联合小梁切除术和全视网膜光凝治疗新生血管性青光眼的效果.方法 前瞻性非随机系列病例研究.对2012年5月至2013年3月在北京同仁医院眼科行玻璃体腔内注射0.5 mg (0.05 ml)雷珠单抗后行小梁切除术联合丝裂霉素,观察术中术后并发症的情况,及术后眼压随访结果.结果 连续接诊的12例(13只眼)接受玻璃体腔内注射雷珠单抗后择期行小梁切除术,随访3～9个月(平均6个月),术后末次随访视力提高者5只眼(38.5％),视力未变者8只眼(61.5％),无视力下降者.术前眼压平均(44.65±15.09) mm Hg(范围22～65 mmHg),术后末次随访的眼压为(17±6.50) mm Hg(范围9～33 mmHg).手术成功的定义为不用药物眼压控制低于21 mmHg.局部用药眼压控制＜21 mmHg定义为部分成功.组中病例完全成功9只眼,2只眼部分成功,2只眼失败眼压失控再次行睫状体光凝术.2只眼术中出现前房少量出血,术后第3天积血全部吸收.病例中无浅前房或脉络膜脱离等发生.结论 雷珠单抗对于减少虹膜和房角的新生血管有效,小梁切除术中术后前房出血,术后滤过区瘢痕化等并发症少,术后半年随访成功率较高.
目的 觀察玻璃體腔內註射雷珠單抗(Lucentis)後聯閤小樑切除術和全視網膜光凝治療新生血管性青光眼的效果.方法 前瞻性非隨機繫列病例研究.對2012年5月至2013年3月在北京同仁醫院眼科行玻璃體腔內註射0.5 mg (0.05 ml)雷珠單抗後行小樑切除術聯閤絲裂黴素,觀察術中術後併髮癥的情況,及術後眼壓隨訪結果.結果 連續接診的12例(13隻眼)接受玻璃體腔內註射雷珠單抗後擇期行小樑切除術,隨訪3～9箇月(平均6箇月),術後末次隨訪視力提高者5隻眼(38.5％),視力未變者8隻眼(61.5％),無視力下降者.術前眼壓平均(44.65±15.09) mm Hg(範圍22～65 mmHg),術後末次隨訪的眼壓為(17±6.50) mm Hg(範圍9～33 mmHg).手術成功的定義為不用藥物眼壓控製低于21 mmHg.跼部用藥眼壓控製＜21 mmHg定義為部分成功.組中病例完全成功9隻眼,2隻眼部分成功,2隻眼失敗眼壓失控再次行睫狀體光凝術.2隻眼術中齣現前房少量齣血,術後第3天積血全部吸收.病例中無淺前房或脈絡膜脫離等髮生.結論 雷珠單抗對于減少虹膜和房角的新生血管有效,小樑切除術中術後前房齣血,術後濾過區瘢痕化等併髮癥少,術後半年隨訪成功率較高.
목적 관찰파리체강내주사뢰주단항(Lucentis)후연합소량절제술화전시망막광응치료신생혈관성청광안적효과.방법 전첨성비수궤계렬병례연구.대2012년5월지2013년3월재북경동인의원안과행파리체강내주사0.5 mg (0.05 ml)뢰주단항후행소량절제술연합사렬매소,관찰술중술후병발증적정황,급술후안압수방결과.결과 련속접진적12례(13지안)접수파리체강내주사뢰주단항후택기행소량절제술,수방3～9개월(평균6개월),술후말차수방시력제고자5지안(38.5％),시력미변자8지안(61.5％),무시력하강자.술전안압평균(44.65±15.09) mm Hg(범위22～65 mmHg),술후말차수방적안압위(17±6.50) mm Hg(범위9～33 mmHg).수술성공적정의위불용약물안압공제저우21 mmHg.국부용약안압공제＜21 mmHg정의위부분성공.조중병례완전성공9지안,2지안부분성공,2지안실패안압실공재차행첩상체광응술.2지안술중출현전방소량출혈,술후제3천적혈전부흡수.병례중무천전방혹맥락막탈리등발생.결론 뢰주단항대우감소홍막화방각적신생혈관유효,소량절제술중술후전방출혈,술후려과구반흔화등병발증소,술후반년수방성공솔교고.
Objective To observe the efficacy of trabeculectomy after intravitreal injection of ranibizumab in the treatment of neovascular glaucoma.Methods The trabeculectomy was performed 4-24 days after intravitreous injection of ranibizumab (Luncentis) 0.5mg (0.05ml).The intraocular pressure and the visual acuity before and after the surgery and complications were recorded.Results Thirteen eyes of 12 patients were received intravitreous injection of ranibizumab followed by Trabeculectomy.The follow-up time was 3-9 months (averaged 6 months).The mean pre-surgery IOP was 44.65±15.09mmHg while the last follow-up IOP was 17±6.50 mmHg (P ＜0.001).Successful rate of the surgery (IOP ＜ 21mmHg with no medication after the surgery):9/13=69.2 ％,Successful rate of the surgery combined with medication (IOP＜ 21mmHg after the surgery):2/13 (15.4％),2 eyes (15.4％) received cyclophotocoagulation after the trabeculectomy.Rate of improved VA after the surgery:5 eyes (38.5％),Rate of sustained VA after the surgery:8 eyes (61.5％).Complications:Incidence rate of anterior chamber hyphema:2/13 (15.4％),the hyphema disappeared 3 days after operation.Incidence rate of choroidal detachment:0％.Conclusions The surgery of trabeculectomy after intravitreal injection of Ranibizumab controls the IOP effectively.And there are little hemorrage and other complications during and after the surgery.
