Therapeutic effect of intravitreal injection of ranibizumab combined with vitrectomy for the treatment of neovascular glaucoma / 中国医师进修杂志

ABSTRACT

Objective To study the therapeutic effect of intravitreal injection of ranibizumab combined with vitrectomy for the treatment of neovascular glaucoma (NVG). Methods The clinical data of 21 NVG patients who had underwent vitrectomy were retrospectively analyzed. The patients were treated with intravitreal injection of ranibizumab 0.5 mg, then were given the vitrectomy after 3 to 5 d after treatment. The whole retinal photocoagulation was performed during the operation. Cataract surgery was combined in 16 patients, and ciliary photocoagulation was combined in another 15 patients. All patients were followed up for 6 to 12 months, and the intraocular pressure, visual acuity and neovascularization of iris (NVI) were observed. Results The rate of NVI symptoms resolving completely 3 weeks after operation was 80.95％(17/21). The intraocular pressure 1 week, 1 month, 3 months and 6 months after operation was significantly lower than that before operation (18.6 ± 5.1), (14.3 ± 4.8), (12.8 ± 4.4), (15.1 ± 3.7) mmHg (1 mmHg=0.133 kPa) vs. (42.8 ± 7.3) mmHg, and there was statistical difference (P<0.05). Two months after operation, 2 cases were not able to control by chemicals, and were treated with transscleral cyclophotocoagulation. Six months after operation, the intraocular pressure was completely controlled in 15 cases, and conditionally controlled in 6 cases. No ocular hypotension occurred. The visual acuity was not improved in 4 cases, but the rest were improved in different degrees. Conclusions For the patients of NVG combined with vitreous hemorrhage and obvious proliferation, intravitreal injection of ranibizumab in the first place, and then combined with vitrectomy, whole retinal photocoagulation and ciliary photocoagulation can obtain good effect.