摘要
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.
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.
出处
《中华眼外伤职业眼病杂志》
2015年第3期180-183,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
青光眼
新生血管性
雷珠单抗
Glaucoma, neovascular
Ranibizumab
Glaucoma drainage device, Ex-press
作者简介
通信作者：刘勤，Email：summliu@126．com
