黄 芳，宋彩萍，于 淼



·临床报告·

新生血管性青光眼联合治疗疗效分析

黄 芳1，宋彩萍1，于 淼2

•METHODS:Twenty-three eyes of 21 patients with neovascular glaucoma were enrolled. The patients of ocular media transparency were treated with intravitreous injection of anti-VEGF drug and PRP combined with filtering surgery. The patients of ocular media opacity were treated with vitrectomy or cataract surgery in the meantime. All cases were followed for 3mo, IOP control were observed after treatment.

•RESULTS:One patient visual acuity improved significantly, all remaining stable or slightly improve visual acuity. All case showed regress at different degree of the iris neovessels. There was significant difference between before and after treatment (P=0.00).

•CONCLUSION:The intravitreous injection of anti-VEGF drug and PRP combined with filtering surgery for neovascular glaucoma provide more rapid control of IOP. It is a better choice of neovascular glaucoma.

目的：观察抗血管内皮生长因子(vascular endothelial growth factor，VEGF)药物玻璃体腔内注射及全视网膜光凝(panretinal photocoagulation，PRP)后联合滤过手术治疗新生血管性青光眼的疗效。

方法：对21例23眼患者中屈光介质透明者行抗VEGF药物玻璃体腔内注射及PRP后新生血管消退后行复合式小梁切除术，屈光介质混浊患者行白内障或玻璃体切除术及全视网膜光凝联合复合式小梁切除术，随访3mo，对治疗前后眼压情况进行比较。

结果：患者1例1眼视力提高显著，其余患者视力稳定或略有提高，所有患者虹膜新生血管均有不同程度消退。治疗前后眼压比较有统计学差异(P<0.01)，所有患者均未出现术中术后严重并发症。

结论：抗VEGF药物玻璃体腔内注射及PRP清除虹膜新生血管后联合滤过手术可以较快、较好地控制眼压，可有效治疗新生血管性青光眼。

眼压；新生血管性青光眼；血管内皮生长因子抑制剂；玻璃体腔注射；小梁切除术

引用：黄芳，宋彩萍，于淼.新生血管性青光眼联合治疗疗效分析.国际眼科杂志2016;16(12):2311-2313

0引言

新生血管性青光眼是继发于视网膜疾病的一种难治性青光眼，占亚洲青光眼的0.7%～5.1%[1-2]，系由于各种原因造成视网膜缺血缺氧，产生血管内皮生长因子(vascular endothelial growth factor，VEGF)[3-5]，进而导致虹膜产生新生血管丛阻塞房角小梁网，引起患者眼压增高。除此之外，血管膜收缩可导致虹膜前粘连、房角关闭，眼压进一步升高。因此，对该类型青光眼，不论是药物还是传统手术均效果不佳[6-8]。我院采用玻璃体腔内注射抗VEGF联合全视网膜光凝后(panretinal photocoagulation，PRP)及传统滤过手术取得良好效果，现报告如下。……