眼科 ›› 2014, Vol. 23 ›› Issue (4): 256-260.doi: 10.13281/j.cnki.issn.1004-4469.2014.04.010

• 论著 • 上一篇    下一篇

Ex-PRESS房水引流物植入术联合抗新生血管药物治疗新生血管性青光眼的一年效果

王怀洲  洪洁  赵博文  桑景荭  王宁利   

  1. 100005首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2014-02-18 出版日期:2014-07-25 发布日期:2014-07-22
  • 通讯作者: 王宁利,Email:wningli@vip.163.com
  • 基金资助:

    卫生部卫生公益性行业科研专项(201002019)

Ex-PRESS miniature glaucoma device implantation combined with anti-VEGF for neurovascular glaucoma  

WANG Huai-zhou, HONG Jie, ZHAO Bo-wen, SANG Jing-hong, WANG Ning-li.   

  1. Beijing Institute of Ophthalmology; Beijing Key Laboratory of Ophthalmology & Visual Sciences; Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2014-02-18 Online:2014-07-25 Published:2014-07-22
  • Contact: WANG Ning-li, Email: wningli@vip.163.com

摘要: 目的 评价Ex-PRESS房水引流物植入术联合玻璃体内注射抗血管内皮生长因子(VEGF)治疗新生血管性青光眼的初步效果。设计 前瞻性干预性病例系列。研究对象 2012年3月至2013年10月北京同仁眼科中心行Ex-PRESS房水引流物植入术的新生血管性青光眼患者16例(16眼)。方法 患者在玻璃体内注射雷珠单抗0.5 mg治疗后5~10天接受Ex-PRESS房水引流物植入术。术后1、2、3天, 1、2、3周,1、3、6、12个月随访。不用药物情况下眼压在21 mmHg以下为完全成功,辅助用降眼压药物下眼压在21 mmHg以下为条件成功。主要指标 眼压、降眼压药物种类及术后并发症。结果 术前平均眼压(44.6±17.8)mmHg;术后1、3、6、12个月平均眼压分别为(12.6±3.5)、(13.8±7.5)、(17.5±6.5)、(22.6±9.5)mmHg。术前应用抗青光眼药物(3.2±1.4)种;术后12个月应用(0.6±0.2)种。术后12个月手术完全成功率81.3%,条件成功率87.5%。术后浅前房3眼,脉络膜脱离2眼,前房积血2眼,眼压失控(>30 mmHg)2眼。结论 Ex-PRESS房水引流物植入术联合抗新生血管药物治疗新生血管性青光眼安全有效,可作为此类患者的选择性手术治疗方式。(眼科, 2014, 23: 256-260)

关键词: 新生血管性青光眼, Ex-PRESS房水引流物植入术

Abstract: Objective To evaluate the efficacy and safety of Ex-PRESS miniature glaucoma device implantation combined with anti-VEGF for neurovascular glaucoma. Design Prospective interventional case series. Participants 16 eyes of 16 patients with neurovascular glaucoma who underwent Ex-PRESS miniature glaucoma device implantation in Tongren Hospital from March 2012 to October 2013. Methods All patients underwent Ex-PRESS miniature glaucoma device implantation on 5-10 days after intravitreous injection 0.5 mg ranibizumab. Followed up was performed at day 1, day 2, day 3, week 1, week 2, week 3, month 1, month 3, month 6, and month 12 after surgery. Main Outcome Measures Intraocular pressure (IOP), numbers of anti-glaucoma medication and postoperative complications. Results Pre-operation mean IOP was 44.6±17.8 mmHg in 16 patients. IOP after Ex-PRESS surgery was (12.6±3.5), (13.8±7.5), (17.5±6.5), and (22.6±9.5) mmHg respectively at month 1, month 3, month 6, and month 12 after surgery. The number of anti-glaucoma medication was (3.2±1.4) before operation and (0.6±0.2) after operation. At the last following up, the complete success rate was 81.3%, and qualified success rate was 87.5%. The postoperative complications included shallow anterior chamber (3 eyes), hyphema (2 eyes), choroidal effusion (2 eyes) and IOP elevation (>30 mmHg) (2 eyes). Conclusions Implantation of Ex-PRESS miniature glaucoma device combined with anti-VEGF treatment can stable lowering IOP and has fewer complications for neurovascular glaucoma. It can be considered as alternative method for management of neurovascular glaucoma. (Ophthalmol CHN, 2014, 23: 256-260)

Key words: neurovascular glaucoma, Ex-PRESS miniature glaucoma device