方法：前瞻性非随机临床研究。所有入选患者先行玻璃体腔注射ranibizumab 0.5mg(0.05mL)，待虹膜和房角新生血管完全消退，再行白内障超声乳化吸除术+人工晶状体植入术+小梁切除术+经睫状体平坦部玻璃体切除术+眼内激光术。术后随访6mo，观察最好矫正视力(best corrected visual acuity，BCVA)、眼压(IOP)、虹膜新生血管(NV)及并发症的变化情况。

结果：入选患者19例19眼，随访6mo所有患者术后视力均有提高。平均IOP显著降低，差异有统计学意义(P<0.01)，从术前60.00±6.98mmHg降至术后1wk 9.68±2.11mmHg、术后1mo 13.32±2.38mmHg、术后3mo 16.37±3.42mmHg、术后6mo 18.32±2.14mmHg。术后所有IOP均控制<21mmHg，其中3眼用1种降眼压药物，2眼用2种降眼压药物。所有眼3～8d内NV消退，仅有1眼在术后36d复发。无严重并发症发生。

结论：玻璃体腔注射ranibizumab辅助白内障超声乳化吸除术+人工晶状体植入术+小梁切除术+经睫状体平坦部玻璃体切除术+眼内激光联合手术可有效、安全地治疗增殖性糖尿病视网膜病变的继发性新生血管性闭角型青光眼。

METHODS:A prospective nonrandomized clinical study was performed. All enrolled patients were initially treated with intravitreal injection of ranibizumab at the dose of 0.5mg(0.05mL). After new vessels(NV)on the iris and the angle of anterior chamber regressed completely, all patients received phacoemulsification(PHACO), intraocular lens implantation(IOL), trabeculectomy(TRAB), pars plana vitrectomy(PPV)and endophotocoagulation(EPC). The changes of best corrected visual acuity(BCVA), intraocular pressure(IOP), NV and complications were observed, and followed up for 6mo.

RESULTS:Nineteen eyes of 19 patients with neovascular glaucoma(NVG)were involved in this study. After followed up for 6mo, postoperative BCVA of all was improved. Mean IOP was decreased significantly(P<0.01)from 60.00±6.98mmHg preoperatively to 9.68±2.11mmHg at 1wk, 13.32±2.38mmHg at 1mo, 16.37±3.42mmHg at 3mo, and 18.32±2.14mmHg at 6mo postoperatively. All eyes had controlled IOP(<21mmHg)at last visit in which 3 eyes needed one kind of anti-glaucoma medication, and 2 eyes needed two kinds of anti-glaucoma medication. All eyes showed regression of NV in 3-8d, and recurrent NV was detected in one eye at 36d postoperatively. No serious complications occurred.

CONCLUSION:Combined surgery of intravitreal injection of ranibizumab as adjunctive treatment for PHACO+IOL+TRAB+PPV+EPC could be safe and effect for neovascular angle-closure glaucoma secondary to PDR.