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@#AIM: To evaluate the effect of Ahmed glaucoma drainage valve implantation and leizumab on neovascularization glaucoma. <p>METHODS: Totally 80 patients(80 eyes)of neovascularization glaucoma(NVG)according to random number table method were divided into 34 cases(34 eyes)of control group and 46 cases(46 eyes)of research group, the control group was treated with Ahmed glaucoma drainage valve implantation, the research group was treated with Ahmed glaucoma valve implantation combined with rezuzumab, clinical curative effect, cytokines, intraocular pressure, vision after 6mo, and complications in both group were compared. <p>RESULTS: Six months after surgery, the total success rate of operation in the research group was higher than that in the control group(<i>P</i><0.05). 4d before surgery, there were no significant differences in intraocular pressure between the two groups(<i>P</i>>0.05). 7d after surgery, intraocular pressure in both groups all decreased, and the research group was lower than that in the control group(<i>P</i><0.05). 6mo after surgery, the improvement rate of vision in the research group was higher than that in the control group(<i>P</i><0.05). Within 6mo of follow-up, the drainage tube obstruction and hyphema rate in the research group were lower than those in the control group(<i>P</i><0.05). There was no difference in corneal edema, anterior chamber exudation, eyeball pain, shallow anterior chamber and low intraocular pressure rate between the two groups(<i>P</i>>0.05).<p>CONCLUSION:Ahmed glaucoma drainage valve implantation combined with rezumab injection can reasonably control intraocular pressure and improve visual function of patients. It is a safe and effective treatment scheme for NVG patients.
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OBJECTIVE:To observe the clinical efficacy and safety of cyclocryosurgery,intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation,intravitreal injection of conbercept combined with compound trabeculectomy in the treatment of neovascular glaucoma(NVG). METHODS:A total of 39 NVG patients(40 eyes)selected from Sichuan People's Hospital during Jun. 2014-Aug. 2016 were divided into group A(16 cases,16 eyes),B(13 cases,14 eyes),C (10 cases,10 eyes)according to different treatment methods. Group A received cyclocryosurgery;group B received Ahmed glaucoma drainage valve implantation after given intravitreal injection of Conbercept ophthalmic injection(0.05 mL,for consecutive 7 d);group C received compound trabeculectomy after given intravitreal injection of Conbercept ophthalmic injection (0.05 mL,for consecutive 7 d). The intraocular pressures of 3 groups were observed before and after treatment,and the rate of intraocular pressure control,visual changes and the incidence of complications were observed after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in intraocular pressure among 3 groups(P>0.05). Seven days,one month,three months and six months after treatment,intraocular pressures of 3 groups were decreased significantly compared to before treatment;intraocular pressure of group B was significantly lower than those of group A and C;group C was significantly lower than group A,with statistical significance(P<0.05). There was no statistical significance in intraocular pressure among 3 groups three and six months after treatment(P>0.05). The rates of intraocular pressure control in 3 groups were 62.5%,85.7% and 70.0% six months after treatment. Vision of 16 eyes in group A kept stable;vision of 3 eyes in group B were improved,that of 1 eye was decreased and those of 10 eyes kept stable;vision of 1 eye in group C was improved, that of 1 eye was decreased,and those of 8 eyes kept stable;there was no statistical significance in rate of intraocular pressure or vision among 3 groups(P>0.05).The incidence of exudation of anterior chamber in group A was significantly higher than group B and C,with statistical significance(P<0.05). There was no statistical significance in the incidence of other complications(P>0.05). Two patients of group A suffered from the increase of blood pressure during the operation,and recovered to normal after symptomatic treatment. No obvious ADR was found in other patients during treatment. CONCLUSIONS:Three kinds of therapy plans can effectively reduce intraocular pressure of NVG patients,and do not influence vision with less adverse reactions. Intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation or compound trabeculectomy can effectively reduce intraocular pressure in short time and the fromer is better than the latter. Above 2 regimens cause low incidence of complications.
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AIM:To investigate the effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma.METHODS:Totally 200 cases (200 eyes) of patients with neovascular glaucoma in our hospital from June 2013 to June 2016 were enrolled in this study.All patients were treated with glaucoma drainage valve implantation.The medical records of the patients were retrospectively analyzed;the evaluation of operation completion was made;intraocular pressure at preoperative and postoperative 1wk,1mo,1a was detected using non-contact tonometry;the corneal endothelial cell density at preoperative and postoperative 1 wk,1mo and 1 a was tested by corneal endothelial microscopy,and visual acuity of patients before operation and at 1 a after operation was recorded.All patients' complications and intervention methods were followed-up and recorded.RESULTS:All patients' complete success rate was 81.0％,the conditional success rate was 92.0％.The proportion of preoperative and postoperative vision without light perception,hand moving to 0.01,0.02-0.05,0.06-＜0.10,≥0.10 had significant difference (P＞0.05).Intraocular pressure before treatment was 42.43±3.43mmHg,and were 13.45 ± 2.34mmHg,15.89 ± 2.67mmHg,16.34±2.88mmHg at 1wk,1mo and 1a after operation respectively,showing significant difference (F=4570.62,P＜ 0.001).Before treatment,corneal endothelial cell density was 2453.67± 342.34/mm2,and were 2216.67-± 332.32/mm2,2087.34 ± 326.45/mm2,1959.67±303.34/mm2 at 1wk,1mo and 1 a after operation respectively,holding significantly different (F=83.42,P＜0.001).There were macular degeneration 20 eyes of hyphema,13 eyes of low pressure,8 eyes of drainage valve displacement and 21 eyes of shallow anterior chamber.CONCLUSION:Ahmed glaucoma drainage valve implantation for neovascular glaucoma can effectively control intraocular pressure but the presence of corneal endothelial cell loss exists,can effectively protect and recover residual vision of patients,relief complications and recover it after simple intervention,it is an effective method for neovascular glaucoma.