抗VEGF联合Ex-press青光眼引流器植入治疗新生血管性青光眼

目的：观察玻璃体腔注射抗VEGF联合Ex－press青光眼引流器植入术对新生血管性青光眼的临床疗效。方法：回顾性分析我院收治的新生血管性青光眼患者20例20眼，15眼行玻璃体腔注射抗VEGF及Ex－press青光眼引流器植入联合PPV术，术中行全视网膜光凝术。另5眼行玻璃体腔注射抗VEGF及Ex－press青光眼引流器植入术，术后7 d行全视网膜光凝。分别观察20例患者术中及术后并发症情况，以及术后1wk，1、3、6mo后的视力、眼压、虹膜新生血管消退情况。结果：治疗前平均眼压为47±5．6mmHg，治疗后1wk，1、3、6mo时平均眼压分别为13．4±3．6、15．3±4．2、16．9±5．3、18．7±6．9mmHg，治疗后各随访时间点眼压较治疗前差异具有统计学意义（ P＜0．05）。 Ex－press青光眼引流器植入术术中及术后并发症主要有早期浅前房、引流管阻塞，经适当治疗后均恢复。滤过泡瘢痕化8眼，但眼压稳定在正常范围。结论：玻璃体腔注射抗VEGF联合Ex－press青光眼引流器植入术可以有效治疗新生血管性青光眼，降低新生血管性青光眼患者的眼压。

Clinical curative effect analysis of the intravitreal injection of anti VEGF antibody combined with Ex-press glaucoma drainage device for neovascular glaucoma

AIM: To observe the clinical curative effect of the intravitreal injection of anti-VEGF antibody combined with the implantation of Ex-press glaucoma drainage device for neovascular glaucoma(NG).

METHODS:A retrospective analysis of 20 patients with NG, who got the intravitreal injection of anti-VEGF antibody combined with the implantation of Ex-press. The visual acuity, intraocular pressure(IOP), iris neovascularization fade and intraoperative and postoperative complications were observed at 1wk, 1, 3 and 6mo postoperatively.

RESULTS:The average IOPs of 20 patients were 47±5.6mmHg, 13.4±3.6mmHg, 15.3±4.2mmHg, 16.9±5.3mmHg and 18.7±6.9mmHg preoperatively and postoperatively 1wk, 1mo, 3mo and 6mo with statistical difference(P<0.05). The intraoperative and postoperative complications of the implantation of Ex-press mainly included early shallow anterior chamber, drainage tube obstruction, filtering bleb scarring. There were 8 eyes with filtering bleb scarring with normal IOP.

CONCLUSION: The intravitreal injection of anti-VEGF antibody combined with implantation of Ex-press is effective for NG, which can significantly reduce the IOP.