康柏西普联合复合式小梁切除术及视网膜光凝治疗新生血管性青光眼

Conbercept combined with trabeculectomy and retinal photocoagulation in the treatment of nevoascular glaucoma

摘要:

目的：探讨玻璃体腔注射康柏西普联合复合式小梁切除术及视网膜光凝治疗新生血管性青光眼的效果和安全性。

方法：回顾性分析2018-01/2020-12在我院就诊的新生血管性青光眼患者47例47眼的临床资料。随访6mo，观察患者治疗前后视力和眼压的变化情况及并发症发生情况。

结果：复合式小梁切除术后6mo，本组患者视力提高25眼(53%)，其中术前无光感8眼中，提高至0.2、0.02各1眼，提高至手动/30cm 2眼，从无光感恢复光感2眼； 视力无变化19眼(40%)； 视力下降3眼(6%)。复合式小梁切除术后6mo，40例40眼未用任何降眼压药物，眼压<21mmHg，手术完全成功率为85%。复合式小梁切除术后1、7d，1、3、6mo眼压分别为15.6±6.2、12.8±5.9、14.7±5.3、17.1±6.9、18.3±6.7mmHg，与入院时眼压(46.0±11.9mmHg)和玻璃体腔注射康柏西普3d后眼压(39.9±12.5mmHg)相比有显著差异(F=106.65，P<0.001)。复合式小梁切除术后出现前房积血3眼，给予药物保守治疗后积血于3～7d完全吸收。

结论：玻璃体腔注射康柏西普联合复合式小梁切除术及视网膜光凝治疗新生血管性青光眼安全、有效。

Abstract:

AIM: To evaluate the effect and safety of conbercept combined with trabeculectomy and retinal photocoagulation in the treatment of nevoascular glaucoma.

METHODS: A retrospectively analysis study. The clinical data of 47 patients(47 eyes)with neovascular glaucoma admitted to Shaanxi Eye hospital from January 2018 to December 2020. The patients were followed up for 6mo to observe the changes of visual acuity and intraocular pressure and the occurrence of complications before and after treatment.

RESULTS: At 6mo after compound trabeculectomy, the visual acuity of this group of patients improved in 25 eyes(53%), among which 8 eyes without light perception before operation, visual acuity increased to 0.2 and 0.02 respectively, to hand motion/30cm in 2 eyes,restoring light perception from no light perception 2 eyes; The visual acuity remained unchanged in 19 eyes(40%)and decreased in 3 eyes(6%). 40 eyes of 40 cases did not use any intraocular pressure lowering drugs, the intraocular pressure <21mmHg and the complete success rate was 85% at the 6mo follow up post-operatively. The intraocular pressures were 15.6±6.2, 12.8±5.9, 14.7±5.3, 17.1±6.9, 18.3±6.7mmHg at 1, 7d, 1, 3 and 6mo after compound trabeculectomy, which were different from the intraocular pressure at admission(46.0±11.9mmHg)and intravitreal intraocular pressure(39.9±12.5mmHg)after 3d of intravitreal injection of conbercept were significantly different(F=106.65, P<0.001). Hyphema occurred in 3 eyes after compound trabeculectomy, and completely absorbed within 3-7d after conservative drug treatment.

CONCLUSION: Intravitreal injection of conbercept combined with compound trabeculectomy and retinal photocoagulation is safe and effective in the treatment of neovascular glaucoma.