| Objective:To evaluate the clinical curative effect of intravitreal Lucentis combined with trabecular resection surgery versus combined with glaucoma valve implantation in the treatment of neovascular glaucoma(NVG). Method:Retrospective analysis of the data of 33 neovascular glaucoma patients(33 eyes)with intravitreal Lucentis injection combined with anti- glaucoma surgery in the Second Affiliated Hospital of Glaucoma Department of Jilin University from December 2013 to October 2015. According to different surgical methods,the patients were divided into two groups:Group A:17 cases(17 eyes),were received Lucentis intravitreal injection combined with trabeculectomy; Group B:16 cases(16 eyes), were received Lucentis intravitreal injec tion combined with glaucoma valve implantation. Group A and B were completed the whole course of panretinal photocoagulation(PRP) as early as possible.All patients were followed up for 6~18 months after operation.Observe and record intraocular pressure(IO P) and visual acuity pre and postoprative,and NVI fade and postoperative complication including shallow anterior chamber,anterior chamber inflammation,hyphema of anterior chamber,obstruction of filtering channel,vitreous hemorrhage,choroidal detachment and atrophy of the eyeball of two groups patients. Results:1. The recurrence rate of N VI in NVG patients without PRP or vitrectomy combined with PRP is higher than those with PRP or vitrectomy combined with PRP, the difference was statistically significant(P<0.05).2. Group A and group B the average postoperative l OP of anti- glaucoma operation of 1 week, 1 month, 3 months, 6 months compared with the average preoperative l OP decreased significantly, group A the average preoperative l OP were 43.88±12.29 mm Hg, the average postoperative l OP were 15.0±5.04 mm Hg,14.47±4.58 mm Hg,16.38±4.46 mm Hg,19.24±10.98 mm Hg respectively;group B the average preoperative l OP were 50.00±13.18 mm Hg, the average postoperative l OP were 12.31±3.81 mm Hg, 14.00±3.78 mm Hg; 16.69±1.78 mm Hg; 20.00±11.67 mm Hg respectively.The difference was statistically significant(P<0.05). The difference of the average preoperative l OP and the average postoperative l OP of 1 week,1 month,3 months, 6 months between group A and B(t=-1.38,P>0.05;t=1.721, P>0.05;t=0.321,P>0.05;t=-2.86,P>0.05;t=-0.194,P>0.05) had no significant difference.3. The achievement ratio of operation of group A and B were 88.24 %and 93.75% respectively. Compared with group A,the achievement ratio of operation of group B is higher,but the difference was not statistically significant(P>0.05).4. Comparing postoperative complications of group A and B,there was no significant difference in the incidence of complications including shallow anterior chamber,anterior chamber inflammation,hyphema of anterior chamber, obstruction of filtering channel,vitreous hemorrhage,choroidal detachment and atrophy of the eyeball between two groups(P>0.05).5.The proportion of group A and B patients with 4 to 5 types of glaucoma medications preoperative were 88.24% and 93.75% respectively,group B is higher than group A, but the difference was not statistically significant(P>0.05); the proportion of group A and B patients without glaucoma medications were 76.47% and 93.75% respectively, group B is higher than group A, but the difference was not statistically significant(P>0.05). Conclusion:1. Intravitreal Lucentis for NVG patients result in N VI atrophy and disappearance,reduce the postoperative complications, make the operation more safe and effective.2. Completing the whole course of PRP or vitrectomy combined with PRP as early as possible after operation of intravitreal Lucentis combined with anti- glaucoma surgery including trabeculectomy and glaucoma valve implantation can inhibit NVI recurrecence for N VG patients.3.Intravitreal Lucentis combined with trabeculectomy and intravitreal Lucentis combined with glaucoma valve implantation both can reduce IOP effectively. |
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