EX—Press植入联合雷珠单抗玻璃体内注射治疗新生血管性青光眼

李丹丹+魏兰+罗杰

[摘要] 目的 探討EX-Press植入联合雷珠单抗玻璃体内注射治疗新生血管性青光眼的临床疗效。 方法 选取我院65例78 眼新生血管性青光眼患者，随机分为观察组33例（40只眼）及对照组32例（38只眼）。对照组单纯给予 Ex-Press引流器植入术，观察组给予雷珠单抗注射联合Ex-Press 引流器植入术。观察两组治疗前和治疗后 1、4周时，两组患者的患眼视力情况和眼压。比较两组患者治疗成功率及并发症发生率。 结果 两组患者手术均获得成功，术后视力均高于治疗前视力（P<0.05）。但观察组治疗后1、4周眼压的眼压明显低于对照组（P<0.05）。两组治疗前视力分布情况比较，差异无统计学意义（P>0.05）；治疗后对照组视力升高情况优于对照组，两组视力分布比较差异有统计学意义（ Z=5.179，P<0.05）。观察组患者的成功率为97.50%，明显高于对照组的86.84%（P<0.05）。观察组患者的并发症总发生率为15.00%，明显低于对照组的26.32%（P<0.05）。 结论EX-Press植入联合雷珠单抗玻璃体内注射治疗新生血管性青光眼临床疗效确切，可以明显提高视力，降低眼压。

[关键词] EX-Press植入；雷珠单抗；玻璃体内注射；新生血管性青光眼

[中图分类号] R775 [文献标识码] A [文章编号] 2095-0616（2017）13-232-03

[Abstract] Objective To observe the Intravitreal implantation of EX-Press combined with intravitreal antibody for the treatment of neovascular glaucoma. Methods 65 cases of 78 eyes with neovascular glaucoma in our hospital were randomly divided into an observation group（40 eyes） and a control group of 32 cases（38 eyes）. Control group： the Ex-Press drainage device was implanted only， and the observation group was given the injection of Ex-Press combined with the drainage device. The visual acuity and intraocular pressure of the two groups were measured in two groups before and after treatment at 1 and 4 weeks. The treatment success rate and complication rate were compared between the two groups. Results Two groups of patients were successfully operated， the postoperative visual acuity was higher than that before treatment（P<0.05）. But the IOP in the observation group was significantly lower than that in the control group at 1 weeks and 4 weeks after treatment（P<0.05）. The distribution of visual acuity were compared between the two groups before treatment， there was no statistically significant difference（P>0.05）； the control group after treatment visual acuity increased than the control group， the two groups was statistically significant difference （Z=5.179， P<0.05）. The success rate of the observation group was 97.50%， which was obviously higher than that of the control group（86.84%，P<0.05）.The total incidence of complications in the observation group was 15.00%， significantly lower than 26.32% in the control group（P<0.05）. Conclusion EX-Press implantation with intravitreal injection of intravitreal injection is effective in the treatment of neovascular glaucoma. It can obviously improve the visual acuity and reduce intraocular pressure.

[Key words] EX-Press implantation； intravitreal injection of monoclonal antibodies to neovascular glaucoma

新生血管性青光眼（NVG）是指虹膜和小梁表面有新生的纤维血管膜，导致周边虹膜前粘连，阻碍房水排出引起的青光眼。本病预后极差，用一般的抗青光眼药物及滤过性手术往往无效。患者有剧烈眼痛、头痛，眼部充血，角膜水肿，常导致失明[1-2]。视力低下为生血管性青光眼的主要表现，顽固眼胀、恶心呕吐、头痛为其主要并发症 [3-4]。目前，青光眼的手术主要采用现代显微外科技术，其临床成功率高达 85.0%，但其有比较严重的术后炎症，并发症较多，给患者造成极大的痛苦。本文旨在观察EX-Press植入联合雷珠单抗玻璃体内注射治疗新生血管性青光眼的效果，现报道如下。

1 资料与方法

1.1 一般资料

选取我院2014年10月～2016年10月期间65例78 眼新生血管性青光眼患者为研究对象。……