目的 探讨玻璃体腔注射雷珠单抗对新生血管性青光眼(NVG)虹膜新生血管消退及眼压控制的效果.方法 将2013年5月至2014年5月在该院就诊的34例NVG(35眼)患者玻璃体腔注射雷珠单抗,3~5 d后行Ex-press引流植入术;术后随访6个月,观察患者视力、眼压、新生血管变化情况,并记录患者并发症发生率.结果 注射雷珠单抗3~5 d后的34例(35眼)N V G患者新生血管完全消退,随访6个月,无新生血管复发病例.34例患者手术完全成功29例(85.29%),条件成功5例(14.71%);术后1、2、3 d,1、2、3周,以及1、3、6个月患者眼压显著低于手术前,手术前后各时段比较,差异均有统计学意义(P<0.05).术后1、2周与术前视力比较,差异无统计学意义(P>0.05),术后3周,1、3、6个月视力均显著高于术前(P<0.05).术后有6例患者出现浅前房,2例患者出现脉络膜脱离,3例患者术后第2~3天前房出现少量出血,对症处理后均有所好转.结论 玻璃体内注射雷珠单抗后联合Ex-press植入术能够有效控制NVG患者眼压,改善患者视功能,且进一步减少术中并发症发生率,是一种安全有效的治疗方案.%Objective To explore the effect of vitreous cavity injection of Lucentis on iris neovascularization fade and intraocular pressure control in the patients with neovascular glaucoma (NVG) .Methods Thirty-four cases(35 eyes) of NVG in our hospital from May 2013 to May 2014 were given the vitreous cavity injection of Lucentis and performed the Ex-press drainage implant oper-ation after 3-5 d;after operation the cases were followed up for 6 months .The visual acuity ,intraocular pressure and neovascular-ization fade were observed .The occurrence rate of complications were recorded .Results Neovascularizations in 34 NVG cases(35 eyes) were completely subsided on 3-5 d after Lucentis injection ,no recurrence cases occurred by 6-month follow up .Among 34 cases ,29 cases(85 .29% ) were complete success and 5 cases(14 .71% ) were conditional success ;the intraocular pressure on postop-erative 1 ,2 ,3 d and at 1 ,2 ,3 weeks ,1 ,3 ,6 months was significantly lower than that before surgery (P<0 .05) ,there were statisti-cally significant differences among different time periods before and after operation (P<0 .05) .The visual acuity had no statistical difference between postoperative 1 ,2 weeks and before operation (P> 0 .05) ,the visual acuity at postoperative 3 weeks ,1 ,3 ,6 months was significantly higher than that before operation (P<0 .05) .After operation ,there were 6 cases of shallow anterior cham-ber ,2 cases of choroidal detachment and 3 cases of anterior chamber small amount of bleeding on postoperative 2-3 d ,all were im-proved by symptomatic treatment .Conclusion Vitreous cavity injection of Lucentis combined with Ex-press implantation can effec-tively and safely control intraocular pressure in NVG patients ,improves the patients′visual acuity ,moreover further reduces the in-cidence of intraoperative complications ,w hich is a safe and effective treatment scheme .
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