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
3期
180-183
,共4页
青光眼,新生血管性%雷珠单抗%青光眼引流器,Ex-press
青光眼,新生血管性%雷珠單抗%青光眼引流器,Ex-press
청광안,신생혈관성%뢰주단항%청광안인류기,Ex-press
Glaucoma,neovascular%Ranibizumab%Glaucoma drainage device,Ex-press
目的 探讨玻璃体内注射雷珠单抗(Lucentis)联合Ex-press青光眼引流器植入治疗新生血管性青光眼的安全性和有效性.方法 19例(21只眼)新生血管性青光眼先于玻璃体内注射雷珠单抗0.05 rnl(含0.5 mg),待虹膜新生血管消退后,行Ex-press青光眼引流器植入,屈光间质清晰者术后行广泛视网膜光凝术(panretinal photocoagulation,PRP).术后观察虹膜及前房角新生血管情况,眼压、视力变化及手术并发症.随访6个月.结果 玻璃体内注药后3～7d,21眼新生血管均全部消退.治疗前平均眼压(52.63±4.64)mmHg(1 mmHg =0.133 kPa);术后1个月平均眼压(13.47±2.34) mmHg,术后3个月为(14.15±:2.69) mmHg,术后6个月为(14.94±3.29) mmHg.术后1、3、6个月眼压与术前相比差异均有统计学意义(t=43.236,42.314,40.637,P＜0.05),术后1、3、6个月眼压相互对比差异无统计学意义(P＞0.05).21只眼中术后视力提高者3只眼,无明显改变者18只眼,无视力下降者.完全成功19只眼,部分成功2只眼.术后并发症:1只眼术后1周出现滤过泡部分球结膜回退、部分巩膜瓣暴露,手术修补后,滤过泡良好.结论 玻璃体内注射雷珠单抗可使新生血管性青光眼的虹膜新生血管迅速消退,为下一步青光眼手术创造良好的条件;Ex-press青光眼引流器植入术的手术创伤较少,术中术后并发症发生率较低等特点,为新生血管性青光眼的治疗开辟了新的纪元,联合雷珠单抗是治疗新生血管性青光眼安全而有效的术式.
目的 探討玻璃體內註射雷珠單抗(Lucentis)聯閤Ex-press青光眼引流器植入治療新生血管性青光眼的安全性和有效性.方法 19例(21隻眼)新生血管性青光眼先于玻璃體內註射雷珠單抗0.05 rnl(含0.5 mg),待虹膜新生血管消退後,行Ex-press青光眼引流器植入,屈光間質清晰者術後行廣汎視網膜光凝術(panretinal photocoagulation,PRP).術後觀察虹膜及前房角新生血管情況,眼壓、視力變化及手術併髮癥.隨訪6箇月.結果 玻璃體內註藥後3～7d,21眼新生血管均全部消退.治療前平均眼壓(52.63±4.64)mmHg(1 mmHg =0.133 kPa);術後1箇月平均眼壓(13.47±2.34) mmHg,術後3箇月為(14.15±:2.69) mmHg,術後6箇月為(14.94±3.29) mmHg.術後1、3、6箇月眼壓與術前相比差異均有統計學意義(t=43.236,42.314,40.637,P＜0.05),術後1、3、6箇月眼壓相互對比差異無統計學意義(P＞0.05).21隻眼中術後視力提高者3隻眼,無明顯改變者18隻眼,無視力下降者.完全成功19隻眼,部分成功2隻眼.術後併髮癥:1隻眼術後1週齣現濾過泡部分毬結膜迴退、部分鞏膜瓣暴露,手術脩補後,濾過泡良好.結論 玻璃體內註射雷珠單抗可使新生血管性青光眼的虹膜新生血管迅速消退,為下一步青光眼手術創造良好的條件;Ex-press青光眼引流器植入術的手術創傷較少,術中術後併髮癥髮生率較低等特點,為新生血管性青光眼的治療開闢瞭新的紀元,聯閤雷珠單抗是治療新生血管性青光眼安全而有效的術式.
목적 탐토파리체내주사뢰주단항(Lucentis)연합Ex-press청광안인류기식입치료신생혈관성청광안적안전성화유효성.방법 19례(21지안)신생혈관성청광안선우파리체내주사뢰주단항0.05 rnl(함0.5 mg),대홍막신생혈관소퇴후,행Ex-press청광안인류기식입,굴광간질청석자술후행엄범시망막광응술(panretinal photocoagulation,PRP).술후관찰홍막급전방각신생혈관정황,안압、시력변화급수술병발증.수방6개월.결과 파리체내주약후3～7d,21안신생혈관균전부소퇴.치료전평균안압(52.63±4.64)mmHg(1 mmHg =0.133 kPa);술후1개월평균안압(13.47±2.34) mmHg,술후3개월위(14.15±:2.69) mmHg,술후6개월위(14.94±3.29) mmHg.술후1、3、6개월안압여술전상비차이균유통계학의의(t=43.236,42.314,40.637,P＜0.05),술후1、3、6개월안압상호대비차이무통계학의의(P＞0.05).21지안중술후시력제고자3지안,무명현개변자18지안,무시력하강자.완전성공19지안,부분성공2지안.술후병발증:1지안술후1주출현려과포부분구결막회퇴、부분공막판폭로,수술수보후,려과포량호.결론 파리체내주사뢰주단항가사신생혈관성청광안적홍막신생혈관신속소퇴,위하일보청광안수술창조량호적조건;Ex-press청광안인류기식입술적수술창상교소,술중술후병발증발생솔교저등특점,위신생혈관성청광안적치료개벽료신적기원,연합뢰주단항시치료신생혈관성청광안안전이유효적술식.
Objective To evaluate the effect and safety of intravitreous injection of Ranibizumab combined with Ex-press miniature glaucoma drainage device implant for neovascular glaucoma (NVG).Methods Twenty-one eyes of 19 patients with angle closure NVG were treated by Ranibizumab intravitreal injection firstly,the Ex-press miniature glaucoma drainage device was implanted following the atrophy of iris neovascularion,then pan retinal photocoagulation was performed,according to the extent of opacity in refractive media postoperatively.Iris,anterior chamber angle neovascularization condition,intraocular pressure,and visual acuity were observed in the following 6 months.Results Iris neovascularization was completely regressed during 3-7 days after injection in 21 eyes.The intraocular pressure of 21 eyes were less than 21 mmHg (1 mmHg =0.133 kPa) without any drugs after combined Ex-press implant.No serious complications were observed after intravitreous iniection and Ex-press implant with MMC.Conclusion Intravitreous injection of Ranibizumab could significantly accelerate the regression of iris neovascularization and avoid haemorrhage during subsequent Ex-press implanting.Which could improves the successful rate of Ex-press implant with MMC and maintain visual function.Intravitreous injection of Ranibizumab combined with Ex-press implant is safe and effective for NVG.
