ABSTRACT
@#AIM: To observe the effects of combined anti-VEGF therapy on neovascular glaucoma.<p>METHODS: A total of 62 patients(68 eyes)with neovascular glaucoma admitted to our hospital from February 2012 to October 2018 were retrospectively analyzed. Group A were given intravitreal injection of anti-VEGF drug(conbercept ophthalmic injection)0.05mL, and complex trabeculectomy was performed 1wk after injection, and total retinal laser photocoagulation was performed 3wk after injection. Cyclocryosurgery was performed in group B. Intraocular pressure(IOP), best corrected visual acuity(BCVA), axial length and postoperative complications of patients in two groups were observed before treatment and 2wk, 1mo, 3mo and 6mo after treatment. <p>RESULTS: The regression degree of iris neocescularization in group A was significantly better than that in group B. IOP at 2wk, 1mo, 3mo and 6mo after surgery in the two groups showed statistical differences(<i>P</i><0.05). There was a statistically significant difference in axial length 6mo after treatment(<i>P</i><0.05). The total effective rate was 94% in anti-VEGF group(group A)and 78% in cyclocryosurgery group(group B), the difference was not statistically significant(<i>P</i>=0.073).<p>CONCLUSION: It is safe and effective for the combined treatment of anti-VEGF drug, combined trabeculectomy and total retinal laser photocoagulation in the treatment of neovascularization glaucoma.
ABSTRACT
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.