康柏西普联合手术及全视网膜光凝 治疗NVG 的临床研究

Application of Compaq combined with trabeculectomy and whole retinal photocoagulation in neovascular glaucoma

摘要:

目的 观察玻璃体腔注射康柏西普联合复合式小梁切除术及全视网膜光凝治疗新生血管性青光眼 （NVG）的临床疗效。方法 选取2014 年1 月-2017 年1 月该院就诊的200 例NVG 患者，共200 只眼。入选患者 屈光间质尚清晰，尚存部分视功能。按是否接受玻璃体腔注射康柏西普药物分为对照组和观察组，每组各100 例（100 只眼）。观察组采用玻璃体腔注射康柏西普+ 复合式小梁切除术+ 全视网膜光凝治疗方案；对照组行复 合式小梁切除术+ 超全视网膜光凝治疗方案。记录患者治疗前，治疗后1 d、1 周、1 个月及6 个月眼压变化、 视力变化、虹膜及房角新生血管消失情况和不良反应情况。结果 治疗后1 d、1 周、1 个月及6 个月两组眼压 比较，采用重复测量设计的方差分析，结果：①两组不同时间的眼压有差异（P <0.05）；②两组间的眼压有差 异（P <0.05）；③两组眼压的变化趋势有差异（P <0.05）。进一步分析发现，在同一时间的两两比较，观察组 治疗后1 d、1 周、1 个月及6 个月的眼压水平均低于对照组（P <0.05）。治疗1 周后，观察组虹膜和房角新生 血管完全消退率高于对照组；观察组消退时间低于对照组。结论 采用玻璃体腔注射康柏西普+ 复合小梁切 除术+ 全视网膜光凝治疗NVG，能有效改善患者治疗效果，减少不良反应，增加治疗的安全性。

Abstract:

Objective To investigate the clinical efficacy of Compaq combined with trabeculectomy and whole retinal photocoagulation in the treatment of neovascular glaucoma. Methods Totally 200 cases of neovascular glaucoma admitted in our hospital from January 2014 to January 2017 were involved in this study. The refractive status of the selected patients was still clear, and visual functions remainedin some degree. Patients in control group received standard treatment of trabeculectomy plus whole retinal photocoagulation regimen. Patients in observation group received intravitreal injection of Compaq in addition to standard treatments.Intraocular pressure, visual acuity and adverse reactions were recorded prior toand 1 d, 1 week, 1 month and 6 months post treatments. Results There were significant differences forintraocular pressure at different recorded time points between the groups (P < 0.05); there was significant differenceforintraocular pressurebetween the groups (P < 0.05); there was significant difference in variation tendency of intraocular pressure between the groups (P < 0.05). Further analysis found that, in comparison with control group, patients in observation group had dramatically decreased intraocular pressureat 1 day, 1 week, 1 month and 6 months after treatments (P < 0.05). After 1 week of treatment, the complete regression rate of iris and angle neovascularization in the observation groupwas increased obviously compared with control group (P < 0.05) with less regression time (P < 0.05). Conclusion The intravitreal injection of Compaq combined with trabeculectomy and ultra retinal photocoagulation is an appropriate therapeutic intervention in treatment of neovascular glaucoma.