Paper - WANFANG MED ONLINE

You Position: Home > Paper

Comparison of efficacy of different doses of Conbercept combined with panretinal photocoagulation and EX - PRESS glaucoma shunt implantation in the treatment of neovascular glaucoma

( views:47, downloads:10 )

Author:: No author available

Journal Title:: International Eye Science

Issue:: 12

DOI:: 10.3980/j.issn.1672-5123.2022.12.24

Key Word:: EX-PRESS引流钉;新生血管性青光眼;康柏西普;全视网膜光凝;玻璃体腔注射

Abstract：目的:评估玻璃体腔注射三种剂量康柏西普联合全视网膜光凝(PRP)后行EX-PRESS引流钉植入术治疗新生血管性青光眼(NVG)的有效性及安全性.方法:前瞻性研究.收集我院2018-05/2020-09收治的NVG患者37例37眼,均接受玻璃体腔注射康柏西普3～5d后行PRP.术后1wk内接受EX-PRESS青光眼引流钉植入术.采用随机数字表法,将术前玻璃体腔注射三种剂量康柏西普分为低剂量组(13眼)、常规剂量组(12眼)、高剂量组(12眼),分别玻璃体腔注射10mg/mL康柏西普0.03、0.05、0.08mL(含康柏西普0.3、0.5、0.8mg).观察三组患者玻璃体腔注药后虹膜及房角新生血管(NV)消退情况,比较三组患者术后眼压(IOP)、最佳矫正视力(BCVA)、并发症.结果:所有患者均完成随访.三组患者玻璃体腔注射后3～5d,虹膜及房角NV消退眼数高剂量组明显高于低剂量组(χ2=0.132,P=0.003)、常规剂量组(χ2=0.154,P=0.015).三组术后1、3、6mo时,BCVA、IOP均较术前有所改善.术后12mo低剂量组、常规剂量组、高剂量组的IOP分别为14.12±2.63、13.37±2.18、12.15±1.43mmHg,高剂量组IOP均低于低剂量组及常规剂量组(均P<0.05).术后12mo高剂量组BCVA均优于低剂量组及常规剂量组(均P<0.05).术后12mo并发症发生率三组之间均无差异(P>0.05).结论:玻璃体腔注射0.8mg高剂量康柏西普联合PRP及EX-PRESS引流钉植入术治疗NVG临床效果尤为显著.

Reference

[1]牛童童,邓月,刘毅,等.康柏西普联合不同手术方式对新生血管性青光眼疗效观察[J].2021,(11).
[2]孔繁学,马翔,范松涛,等.玻璃体腔注射雷珠单抗和康柏西普联合青光眼引流阀植入治疗新生血管性青光眼的疗效[J].2017,(6).
[3]高传文,陈伟,杨潇远,等.Ex-Press房水引流物植入术治疗新生血管性青光眼临床观察[J].2018,(8).
[4]赵媛,余敏,代艳,等.康柏西普联合EX-PRESS青光眼引流器植入对NVG患者视力及并发症的影响[J].2020,(10).
[5]贾旭,段宣初.抗血管内皮生长因子类药物在新生血管性青光眼及滤过手术抗瘢痕治疗中的应用[J].2015,(4).
[6]Simsek, Tulay,Bilgec, Mustafa Deger.Ahmed glaucoma valve implantation versus suprachoroidal silicone tube implantation following the injection of bevacizumab into the anterior chamber in patients with neovascular glaucoma[J].2019,257(4).
[7]Mark, Slabaugh,Sarwat, Salim.Use of Anti-VEGF Agents in Glaucoma Surgery.[J].2017,2017(Spec ).
[8]Arcieri, Enyr S.,Paula, Jayter S.,Jorge, Rodrigo,etc.Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up[J].2015,93(1).
[9]Yoichiro, Shinohara,Hideo, Akiyama,Mikiya, Magori,etc.Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma.[J].2017,11(Spec ).
[10]Yilmaz, Suzan Guven,Yildirim, Seyda,Degirmenci, Cumali,etc.Evaluation of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in refractory neovascular glaucoma[J].2016,26(6).
[11]Kazuyuki,Kawabata,Kohei,Shobayashi,Keiichiro,Iwao,etc.Efficacy and safety of Ex-PRESS® mini shunt surgery versus trabeculectomy for neovascular glaucoma: a retrospective comparative study.[J].2019,19(1).
[12]Shi Liukun,Yang Jin,Lin Jinyong.What is the impact of intravitreal injection of conbercept on neovascular glaucoma patients: a prospective, interventional case series study[J].2019,19(1).
[13]Minwen Zhou,Jiawei Wang,Xiaodong Sun.Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up[J].2016,(1).
[14]Junki, Kwon,Kyung Rim, Sung.Effect of Preoperative Intravitreal Bevacizumab on the Surgical Outcome of Neovascular Glaucoma at Different Stages.[J].2017,2017(Spec ).
[15]Kurtz, Shimon,Tzur, Rotem,Moisseiev, Elad,etc.Standard Trabeculectomy and Ex-PRESS Miniature Glaucoma Shunt: A Comparative Study and Literature Review[J].2015,24(6).
[16]J B, Jonas,D, Yang,N, Wang.[Effect of intraocular pressure on glaucomatous damage to the optic nerve].[J].2014,111(2).
[17]Zhan,Xie,Hai,Liu,Mulong,Du,etc.Efficacy of Ahmed Glaucoma Valve Implantation on Neovascular Glaucoma.[J].2019,16(10).
[18]张秀兰,王家伟.难治性青光眼的治疗策略[J].2015,(3).
[19]Andreas Katsanos,Kostantina Gorgoli,Dimitrios G. Mikropoulos,etc.Assessing the role of ranibizumab in improving the outcome of glaucoma filtering surgery and neovascular glaucoma[J].2018,18(6).
[20].Long-Term Results of Ahmed Glaucoma Valve in Association With Intravitreal Bevacizumab in Neovascular Glaucoma[J].2015,24(5).
[21]D I, WEISS,R N, SHAFFER,T R, NEHRENBERG.Neovascular gluacoma complicating carotid-cavernous fistula.[J].1963,69.
[22]M A,Karpilova,M H,Durzhinskaya.[Anti-VEGF drugs in the treatment of neovascular glaucoma].[J].2019,135(5. Vyp. 2).
[23]Shane J, Havens,Vikas, Gulati.Neovascular Glaucoma.[J].2016,55.
[24]Riva, Ivano,Roberti, Gloria,Katsanos, Andreas,etc.A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations[J].2017,34(4).
[25]Arathi,Simha,Kanza,Aziz,Andrew,Braganza,etc.Anti-vascular endothelial growth factor for neovascular glaucoma.[J].2020,2.
[26]Seibold,L.K.,Soohoo,J.R.,Kahook,M.Y..Recent advances in the management of neovascular glaucoma[J].2013,28(3).
[27]Hayreh SS.Neovascular glaucoma.[J].2007,26(5).
[28]Salim,S..The role of the Ex-PRESS glaucoma filtration device in glaucoma surgery[J].2013,28(3).
[29]Meltem Guzin Altinel,Ayse Yagmur Kanra,Remzi Karadag,etc.Ex-PRESS implantation for different types of glaucoma[J].2019,(8).