The Clinical Therapeutic Effect Of Intravitreal Lucentis Injection Combined With Operation In Treatment Of Neovascular Glaucoma Associated With Vitreous Hemorrhage

Objective:To observe the clinical effect on neovascular glaucomawith vitreous hemorrhage patients by intravitreal injection of vascularendothelial growth factor inhibitors (lucentis) combined with vitrectomy andtrabeculectomy.Methods: Retrospective analysis of the data of23patients (27eyes)who was suffered from vitreous hemorrhage with neovascular glaucomaand treated in our hospital from January2010to October2014.Thepatients were divided into two groups: GroupA:8patients(10eyes):trabeculectomy+vitrectomy+PRP(in-operation);GroupB:15patients(17eyes): lucentis injection+trabeculectomy+vitrectomy+PRP(in operation).Thesame surgical procedures performed by the same surgeon,.They werefollowed up for2-8months after the surgery, average5.2months. Thepreoperative and postoperative visual acuity cases, intraocular pressure,anterior segment, vitreous cavity and other complications was observed,recorded,and statistically analyzed.Results:1.The recovery of visual acuity and intraocular pressureof patients in group B were better than group A, the difference wasstatistically significant (P <0.05);2.In and after trabeculectomy,theanterior chamber bleeding of patients in group B is litter than A group, thedifference was statistically significant (P<0.05).3.Unther control ofintraocular pressure after trabeculectomy, there were less postoperativebleeding, significantly operation time, etc in group B than group A invitrectomy surgery,the difference was statistically significant (P<0.05);4.During postoperative follow-up, recurrent neovascularization andrecurrent bleeding in patients，eye of group B were less than the groupA,the difference was statistically significant (P <0.05);5.In group B thesurface of the iris and neovascular in Anterior chamber subsided aboutone week after intravitreal Lucentis injection and no significantcomplications and adverse reactions occurred.Conclusion:1.Lucentis intravitreal injection combined trabeculectomywith vitrectomy and PRP in treatment of neovascular glaucoma associatedwith vitreous hemorrhage patients can improve visual acuity, it is a safeand effective method;2.This combined method can reduce intraocularpressure;3.Lucentis intravitreal injections can reduce intraoperative and postoperative bleeding in trabeculectomy effectly;4.Lucentis intravitrealinjections can reduce intraoperative and postoperative bleeding, shorteroperating time and also reduce injury of retina during vitrectomy;5.Lucentis intravitreal injection have a significant effect and satety forneovascular regression，but neovascutarization may be recurrent.