目的：探究EX-PRESS联合贝伐单抗治疗难治性青光眼的疗效。

方法：回顾性分析2014-06/2016-12我院采用EX-PRESS青光眼引流器植入术治疗的难治性青光眼患者150例150眼的病历资料，将只采用EX-PRESS治疗的患者70例70眼设为对照组，在此基础上运用玻璃体腔注射贝伐单抗治疗的患者80例80眼设为观察组。评价手术成功率； 采用非接触式眼压计测量术前、术后7d，1、3、6mo眼压，并记录术前、术后6mo视力情况以及术后并发症发生情况。

结果：术后6mo，观察组手术完全成功率(72.5%)显著高于对照组(58.6%)，部分成功率(17.5%)显著低于对照组(30.0%)，差异均有统计学意义(χ²=5.453，P=0.028，χ²=4.213，P=0.047)； 两组手术失败率比较，差异无统计学意义(χ²=0.000，P=1.000)。两组手术前后视力比较，差异均无统计学意义(P>0.05)。两组患者治疗前后眼压比较，差异有统计学意义(F_组间=982.27，P_组间<0.05； F_时间=941.88，P_时间<0.05)； 两组治疗后眼压均显著降低，术后7d观察组显著高于对照组，差异有统计学意义(P<0.05)； 术后1、3、6mo，两组眼压比较，差异均无统计学意义(P>0.05)。观察组低眼压、前房出血、浅前房发生率均显著性低于对照组，差异均有统计学意义(P<0.05)。

结论：玻璃体腔注射贝伐单抗联合EX-PRESS治疗难治性青光眼能够提升手术的完全成功率，有效控制术后短期眼压，前房出血、低眼压等并发症发生率较低。

METHODS: The research objects were 150 cases(150 eyes)of patients with refractory glaucoma from June 2014 to December 2016 in our hospital. All patients were treated with EX-PRESS glaucoma drainage device implantation, and their medicine data were analyzed retrospectively. Totally 70 cases(70 eyes)were treated with EX-PRESS only were set as the control group; 80 cases(80 eyes)received bevacizumab intravitreal injection on the basis of the treatment of the control group were set as the observation group. The successful rate of operation was evaluated, the intraocular pressure was measured before operation and at 7d, 1, 3, 6mo after treatment by non-contact conometer, followed by record of the visual acuity and complications before and after 6mo of treatment.

RESULTS: The observation group's total surgical success rate was 72.5%, which was sharply higher than that of the control group(58.6%); while the partial success rate was 17.5%, which was significantly lower than that of the control group(30.0%), with statistical significance(χ²=5.453, P=0.028; χ²=4.213, P=0.047). Two groups' surgical failure rate had no distinct difference(χ²=0.000, P=1.000). There was no significant difference in visual acuity of the two groups before and after operation(P>0.05). There was no significant difference in intraocular pressure between the two groups(F_groups=982.27, P<0.05; F_time=941.88, P<0.05). The intraocular pressure of the two groups decreased significantly after treatment, and at the 7d observation group was significantly higher than that of the control group after operation(P<0.05). After 1, 3, 6mo of operation, there was no abvious difference between two groups on IOP(P>0.05). The observation group's low intraocular pressure, anterior chamber bleeding and shallow anterior chamber incidence were significantly lower than those of the control group, there was statistical meaning(P<0.05).

CONCLUSION: Intravitreal injection of bevacizumab combined with EX-PRESS in the treatment of refractory glaucoma can improve the complete success rate, as well as perform effective control on complications such as short-term intraocular pressure, hyphema, low intraocular pressure.