| Objective:To investigate the efficacy and safety of anti-vascular endothelial growth factor（anti-VEGF）drugs in inhibiting the growth of corneal neovascularization（CNV）after corneal transplantation.Methods:In this study,30 patients（30 eyes）who underwent penetrating corneal transplantation in the Second People’s Hospital of Jinan from January 2020 to December 2020 and were diagnosed with viral keratitis preoperatively,had CNV in all four quadrant of the corneal implant when receiving corneal transplantation,and had CNV invasion in the graft during routine review after surgery w ere included as the subjects.These 30 patients were randomly divided into two groups.The control group（15 cases）only received routine anti-inflammatory and anti-rejection treatment（1%prednisolone acetate eye drops were given to the affected eyes four times a day,1～2 drops each time;Tacrolimus eye drops,1～2 drops per eye twice a day）;In the observation group（15 cases）,routine anti-inflammatory and anti-rejection treatments were given,and at the same time,anti-VEGF drugs were injected into corneal stroma（the injection dose was 0.1ml/time,once every three weeks,three times in total）.Every week,patients were routinely reexamined,slit lamp images were taken,and the invasion length,diameter and area of CNV were measured.Corneal fluorescein sodium staining,corrected visual acuity,intraocular pressure and corneal endothelial count were performed.The observation period was 9 weeks.In this study,statistical methods such as S-W test,variance analysis and T test were used to analyze the data obtained.Results:In the control group,the invasion length of CNV increased from（1.734±0.118）mm to（1.778±0.131）mm,the diameter increased from（0.0682±0.0060）mm to（0.0710 ±0.0070）mm,and the area increased from（20.259±2.095）mm2 to（20.447±2.205）mm2.Compared with the length,diameter and area of CNV at two adjacent observation time points in the control group were all P<0.001,with significant difference.In the observation group,the length of CNV was shortened from（1.736±0.107）mm to（1.098±0.158）mm,the diameter was reduced from（0.0685±0.0072）mm to（0.0534±0.0065）mm,and the area was reduced from（2.25）But in the third week,the length of CNV increased to（1.259±0.156）mm,the diameter widened to（0.0555±0.0068）mm,and the area increased to（14.317±2.662）mm2.The length of CNV was shortened to（0.932±0.168）mm,the diameter was narrowed to（0.0452±0.0056）mm,and the area was reduced to（11.581±2.745）mm2 in the first and second weeks after the second injection treatment,and the length of CNV increased to（1.004）in the third week The length of CNV was shortened to（0.620±0.195）mm,the diameter was reduced to（0.0336±0.0052）mm and the area was reduced to（9.670±1.728）mm2in the first and second weeks after the third injection treatment,and the length of CNV increased to（0.699 0）in the third week.Compared with the length,diameter and area of CNV at two adjacent observation time points in the observation group were all P<0.001,with significant statistical differences.At each observation time point after drug injection,compared with the observation group,the length,diameter and area of CNV in the control group and the observation group were all P<0.001,showing statistically significant differences.During the observation period,the corneal fluorescein sodium staining in the control group and the observation group was negative,and the visual acuity,intraocular pressure and corneal endothelial count had no obvious changes.Conclusion:Injecting anti-VEGF drugs into corneal stroma can inhibit CNV in a certain period of time,shorten the length,narrow the diameter and reduce the area of CNV,and effectively control the invasion of CNV into implant.Intrastromal injection of anti-VEGF drugs is safe,and no adverse reactions were found during the observation period. |
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