康柏西普联合EX-PRESS青光眼引流器植入对NVG患者视力及并发症的影响

Effect on vision and complications of Conbercept combined with EX-PRESS glaucoma drainage device implantation for patients with neovascular glaucoma

摘要:

目的：探讨玻璃体腔注射康柏西普联合EX-PRESS青光眼引流器植入对新生血管性青光眼(NVG)患者视力及并发症的影响。

方法：选取2016-02/2018-10我院眼科收治的NVG患者128例，依据患者的治疗方法分为EX-PRESS组(n=66)和小梁切除术组(n=62)，两组患者接受玻璃体腔注射康柏西普治疗，EX-PRESS组患者加行EX-PRESS青光眼引流器植入术治疗，小梁切除术组患者则加行小梁切除术治疗。比较两组手术疗效及术后眼压变化、视力改善情况及并发症发生情况。

结果：术后12mo时，EX-PRESS组、小梁切除术组手术治疗总成功率分别为81.8%(54/66)、72.6%(45/62)(P>0.05)； 术后1、7d，1、3、6、12mo，两组患者眼压均显著低于术前(P<0.05)，但两组患者眼压无差异(P>0.05)； 术后6mo，EX-PRESS组患者视力改善情况显著优于小梁切除术组患者(P<0.05)； EX-PRESS组、小梁切除术组术后并发症总发生率分别为27.3%(18/66)、37.1%(23/62)(P>0.05)。

结论：玻璃体腔注射康柏西普联合EX-PRESS青光眼引流器植入术与联合小梁切除术治疗NVG的有效性、安全性相似，而前者在改善视力方面更具优势。

Abstract:

AIM: To investigate the effect on vision and complications of Conbercept combined with EX-PRESS glaucoma drainage device implantation for patients with neovascular glaucoma(NVG).

METHODS: Totally 128 cases of patients with NVG admitted to ophthalmology in our hospital from February 2016 to October 2018 were selected and divided into EX-PRESS group(n=66)and Trabeculectomy group(n=62)according to their treatment methods. Patients in both groups received conbercept intravitreal injection, patients in EX-PRESS group were treated with EX-PRESS glaucoma drainage device implantation, and patients in Trabeculectomy group were treated with Trabeculectomy. The surgical efficacy, postoperative intraocular pressure, visual acuity improvement and complications were compared between the two groups.

RESULTS: At 12mo postoperatively, the total successful rate of surgery in the EX-PRESS group and Trabeculectomy group were 81.8%(54/66)and 72.6%(45/62), respectively. There was no significant difference on the surgical efficacy between the two groups(P>0.05). At 1d, 7d, 1mo, 3mo, 6mo, 12mo postoperatively, the two group were significantly lower than preoperation(P<0.05), but there was no significant difference on intraocular pressure between the two groups(P>0.05). At 6mo, 12mo postoperatively, the vision improvement of EX-PRESS group was significantly better than that of Trabeculectomy group(P<0.05). The total postoperative complication rate of EX-PRESS group and Trabeculectomy group were 27.3%(18/66)and 37.1%(23/62), respectively(P>0.05).

CONCLUSION: The effectiveness and safety of conbercept intravitreal injection combined with EX-PRESS glaucoma drainage device implantation is similar to combined trabeculectomy for patients with NVG, and the former is more advantageous in improving eyesight.