临床眼科杂志
臨床眼科雜誌
림상안과잡지
JOURNAL OF CLINICAL OPHTHALMOLOGY
2015年
3期
206-209
,共4页
罗恒%侯飞%樊宁%赖铭莹
囉恆%侯飛%樊寧%賴銘瑩
라항%후비%번저%뢰명형
新生血管性青光眼%青光眼阀%贝伐珠单抗
新生血管性青光眼%青光眼閥%貝伐珠單抗
신생혈관성청광안%청광안벌%패벌주단항
Neovascular glaucoma%Glaucoma valve%Bevacizumab
目的观察玻璃体腔注射贝伐珠单抗联合青光眼阀植入术治疗新生血管性青光眼（NVG）的早期疗效。方法对2013年4月至2014年10月在我科行贝伐珠单抗联合青光眼阀植入术治疗的NVG患者39例（40只眼），先行玻璃体腔注射贝伐珠单抗0．06 ml（1．5 mg），手术后1～2周待虹膜新生血管消退后行青光眼阀植入术。术后观察视力、眼压、角膜水肿程度、虹膜新生血管消退情况及术中、术后并发症，随访1个月。结果玻璃体腔注射贝伐珠单抗后1～2周内40只眼虹膜新生血管均明显消退。青光眼引流阀植入术后，38只眼眼压≤21 mmHg，2只眼联合1～2种抗青光眼药物眼压≤21 mmHg，术后1个月检查平均眼压（9．38±5．17）mmHg，与术前平均眼压（44．76±10．59）mmHg比较，差异有统计学意义（t ＝19．62，P ＝0．000）。眼压控制后患者角膜水肿均获得改善。视力较手术前无改善。全部病例在玻璃体腔注射贝伐珠单抗及青光眼阀植入术中未发生并发症。术后早期并发症包括前房消失9只眼，引流管移位2只眼，引流管内口阻塞1只眼，局限出血性脉络膜脱离1只眼。结论贝伐珠单抗联合青光眼阀治疗NVG成功率较高，术后早期眼压控制良好，并发症少，是目前治疗NVG较好的选择，其长期疗效需进一步观察。
目的觀察玻璃體腔註射貝伐珠單抗聯閤青光眼閥植入術治療新生血管性青光眼（NVG）的早期療效。方法對2013年4月至2014年10月在我科行貝伐珠單抗聯閤青光眼閥植入術治療的NVG患者39例（40隻眼），先行玻璃體腔註射貝伐珠單抗0．06 ml（1．5 mg），手術後1～2週待虹膜新生血管消退後行青光眼閥植入術。術後觀察視力、眼壓、角膜水腫程度、虹膜新生血管消退情況及術中、術後併髮癥，隨訪1箇月。結果玻璃體腔註射貝伐珠單抗後1～2週內40隻眼虹膜新生血管均明顯消退。青光眼引流閥植入術後，38隻眼眼壓≤21 mmHg，2隻眼聯閤1～2種抗青光眼藥物眼壓≤21 mmHg，術後1箇月檢查平均眼壓（9．38±5．17）mmHg，與術前平均眼壓（44．76±10．59）mmHg比較，差異有統計學意義（t ＝19．62，P ＝0．000）。眼壓控製後患者角膜水腫均穫得改善。視力較手術前無改善。全部病例在玻璃體腔註射貝伐珠單抗及青光眼閥植入術中未髮生併髮癥。術後早期併髮癥包括前房消失9隻眼，引流管移位2隻眼，引流管內口阻塞1隻眼，跼限齣血性脈絡膜脫離1隻眼。結論貝伐珠單抗聯閤青光眼閥治療NVG成功率較高，術後早期眼壓控製良好，併髮癥少，是目前治療NVG較好的選擇，其長期療效需進一步觀察。
목적관찰파리체강주사패벌주단항연합청광안벌식입술치료신생혈관성청광안（NVG）적조기료효。방법대2013년4월지2014년10월재아과행패벌주단항연합청광안벌식입술치료적NVG환자39례（40지안），선행파리체강주사패벌주단항0．06 ml（1．5 mg），수술후1～2주대홍막신생혈관소퇴후행청광안벌식입술。술후관찰시력、안압、각막수종정도、홍막신생혈관소퇴정황급술중、술후병발증，수방1개월。결과파리체강주사패벌주단항후1～2주내40지안홍막신생혈관균명현소퇴。청광안인류벌식입술후，38지안안압≤21 mmHg，2지안연합1～2충항청광안약물안압≤21 mmHg，술후1개월검사평균안압（9．38±5．17）mmHg，여술전평균안압（44．76±10．59）mmHg비교，차이유통계학의의（t ＝19．62，P ＝0．000）。안압공제후환자각막수종균획득개선。시력교수술전무개선。전부병례재파리체강주사패벌주단항급청광안벌식입술중미발생병발증。술후조기병발증포괄전방소실9지안，인류관이위2지안，인류관내구조새1지안，국한출혈성맥락막탈리1지안。결론패벌주단항연합청광안벌치료NVG성공솔교고，술후조기안압공제량호，병발증소，시목전치료NVG교호적선택，기장기료효수진일보관찰。
Objective To observe the early curative effect of intravitreal bevacizumab and glaucoma valve implan-tation in the treatment of neovascular glaucoma. Methods A retrospective random case series study was performed during the period of 2013 April to 2014 October in our department. Forty eyes of thirty-nine cases who presented with neovascular glaucoma were first treated with intravitreal bevacizumab 1. 5mg in 0. 06ml,then with glaucoma valve implantation after iris neovessels regressed. All cases were followed up for 1 month,and visual acuity,IOP control,corneal edema,regression of i-ris neovessels,and complications were observed after the surgery. Results All the iris neovessels were regressed at different degree within 1 ~ 2 weeks after injection. At final follow-up,the IOP of 38 eyes were normal without any drugs and of 2 eyes with 1 ~ 2 kinds of anti-glaucoma drugs after combined glaucoma valve implantation. Before the surgery,the average IOP was (44. 76 ± 10. 59)mmHg,and after the surgery,it was (9. 38 ± 5. 17)mmHg. There was significant difference between them(t = 19. 62,P = 0. 000)at final follow-up. Corneal edema was improved after the IOP decreased. Visual acuity was no changed in all cases after the operation. No complication was during intravitreal bevacizumab and glaucoma valve implan-tation. The early postoperative complications included anterior chamber disappeared of 9 eyes,tube displacement of 2 eyes, obstruction of tube tip of 1 eye and limitations of hemorrhagic choroidal detachment of 1 eye. Conclusion Intravitreal bev-acizumab and glaucoma valve implantation in the treatment of neovascular glaucoma has a relatively high success rate. It is a better choice for treatment of neovascular glaucoma.
