目的：探讨增殖性糖尿病视网膜病变(PDR)合并早期新生血管性青光眼患者采用雷珠单抗注射联合玻璃体切割术(PPV)治疗的临床效果。

方法：选取2014-07/2016-12我院眼科中心治疗的80例80眼PDR合并早期新生血管性青光眼患者，根据患者术前是否注射雷珠单抗分为预处理组(40例40眼，术前雷珠单抗注射联合PPV治疗)和常规组(40例40眼，仅采取PPV手术治疗)，对比两组患者的视力、眼压等指标变化。

结果：预处理组患者的手术时间、新生血管出血次数、电凝使用次数均显著的低于常规组患者，差异均具有统计学意义(P<0.05)； 术前两组患者的眼压、BCVA测定值比较，差异均无统计学意义(P>0.05)； 术后1wk，3mo，预处理组患者的BCVA值显著优于常规组(P<0.05)，术后1wk时，预处理组患者的眼压低于常规组(P<0.05)； 术前两组患者的房水中VEGF比较，差异无统计学意义(P>0.05)； 术后1mo，预处理组患者房水中VEGF显著低于常规组(P<0.05)，术后3mo时，预处理组患者视网膜黄斑中心凹厚度值低于常规组(P<0.05)。

结论：PDR合并早期新生血管性青光眼患者采用雷珠单抗注射联合PPV治疗能显著地降低手术难度，提高术后视力，降低房水中VEGF的水平。

METHODS: Totally 80 patients(80 eyes)of PDR patients with early neovascular glaucoma were selected in the patients went to Ophthalmic Center from July 2014 to December 2016. According to whether the injection of ranibizumab taken, they were divided as pretreatment group(40 patients 40 eyes, preoperative ranibizumab injection combined with PPV treatment), conventional group(40 patients 40 eyes, only taken PPV surgery). The changes of visual acuity, intraocular pressure and other indicators were compared between the two groups.

RESULTS: The operation time, neovascular bleeding times, coagulation times of pretreatment groups were significantly lower than those of the conventional group, the differences were statistically significant(P<0.05). The differences of preoperative intraocular pressure, BCVA between the two groups were not statistically significant(P>0.05). At 1wk, 3mo after the surgery, the BCVA of pretreatment group was better than that of conventional group(P<0.05). At 1wk after the operation, the IOP of pretreatment group were lower than that of conventional group(P<0.05). The preoperative VEGF in aqueous humor of the two groups was not significantly different(P>0.05). At 1mo after operation, VEGF in aqueous humor of the pretreatment group was significantly lower than conventional group(P<0.05). At 3mo after operation, the fovea retinal thickness of pretreatment group was lower than that of the conventional group(P<0.05).

CONCLUSION: Ranibizumab combined with PPV can significantly reduce the difficulty of operation in PDR patients with early neovascular glaucoma, improve the postoperative visual acuity, and reduce the level of VEGF in aqueous humor.