前列腺素类药结合玻璃体腔注射雷珠单抗治疗新生血管性青光眼的效果

摘要

目的：探讨前列腺素类药结合玻璃体腔注射雷珠单抗治疗新生血管性青光眼的效果。方法伴发高眼压的新生血管性青光眼患者160例根据随机数字表法分为治疗组80例与对照组80例，两组都给予复合式小梁切除术，对照组选择拉坦前列腺素辅助治疗，治疗组选择拉坦前列腺素联合玻璃体腔注射雷珠单抗辅助治疗。结果治疗后治疗组与对照组的治疗有效率分别为97.5%和88.8%，治疗组的治疗有效率明显高于对照组(P<0.05)。两组治疗后最佳矫正视力都明显提高，而眼压都明显下降，与治疗前对比差异明显(P<0.05)；同时治疗后治疗组的最佳矫正视力与眼压也都明显好于对照组(P<0.05)。治疗期间治疗组的眼结膜充血、前房炎症反应、角膜水肿、一过性视觉模糊等并发症发生率都明显低于对照组(P＜0.05)。所有患者治疗后随访调查6个月，治疗组的治疗后3个月与6个月的复发率分别为1.3%和5.0%，而对照组分别为7.5%和13.8%，治疗组治疗后3个月与6个月的复发率明显少于对照组(P＜0.05)。结论前列腺素类药结合玻璃体腔注射雷珠单抗治疗新生血管性青光眼能促进眼压的降低，改善视力水平，安全性好，降低复发，从而有利于近远期疗效的提高。%Objetive To investigate the effects of prostaglandin analogs combined intravitreal ranibizumab treatment for neovascular glaucoma. Methods 160 cases of ocular neovascular glaucoma were randomly and equally divided into the treatment group and the control group. Each group undertakes compound trabeculectomy. The control group was combined with latanoprost adjuvant therapy, and the treatment group was combined with latanoprost and intravitreal ranibizumab injection. Results After treatment, the response rates in the treatment group and the control group were 97.5% and 88.8% respectively, and the treatment group had significantly higher response rate (P<0.05). After treatment, the best corrected visual acuity were improved significantly, while intraocular pressure were significantly decreased, and the compared difference before treatment were significantly (P<0.05). The effect of the treatment group were also significantly better than the control group (P<0.05). The conjunctiva hyperemia, anterior chamber inflammation, corneal edema, transient blurred vision complication rates in the treatment group during treatment were significantly lower than the control group (P <0.05). All patients were followed up for 6 months after treatment. The recurrence rate of three-month and six-month in treatment group after treatment were 1.3% and 5.0%, respectively, while the control group were 7.5% and 13.8%. There was significant difference (P<0.05). Conclusion prostaglandin analogs combined intravitreal ranibizumab treatment for neovascular glaucoma can decrease intraocular pressure, improve visual acuity. It is safe and effective.