目的：研究玻璃体切除联合玻璃体腔注射康柏西普治疗息肉状脉络膜血管病变(polypoidal choroidal vasculopathy，PCV)并发玻璃体积血的临床效果。

方法：回顾性分析我院2013-05/2016-08收治入院行玻璃体切除术治疗患者59例59眼的病例资料，其中21眼仅予以玻璃体切除设为对照组； 38眼玻璃体切除联合康柏西普玻璃体腔注射设为观察组。观察两组患者治疗效果和安全性。

结果：随访12mo结束时，观察组眼底彩色照相可见38眼患者视网膜深层、浅层出血和渗出均完全吸收，且B超检查可见所有患者视网膜下积血完全吸收； 对照组经玻璃体切除后12mo眼底检查可见玻璃体腔积血完全吸收，但有18眼患者视网膜下伴不同程度出血、渗出，B超检查可见视网膜下仍有少量积血。两组患者治疗前后最佳矫正视力变化差异有统计学意义(P<0.01)。治疗后1、3、6、12mo观察组最佳矫正视力均明显优于对照组，组间差异有统计学意义(P<0.05)。两组患者治疗前后黄斑中心凹视网膜厚度变化差异有统计学意义(P<0.01)。观察组术后1wk，1、3、6、12mo黄斑中心凹视网膜厚度均明显低于对照组，组间差异有统计学意义(P<0.05)。观察组康柏西普玻璃体腔注射后1wk，37眼患者前房和虹膜新生血管完全消退，仅1眼残留少量明显萎缩的新生血管，消退率为97%； 对照组玻璃体切除术后1wk，16眼新生血管明显消退，消退率为76%，组间差异有统计学意义(χ²=35.680，P<0.001)。两组患者随访均未见严重并发症，且组间不良反应发生率差异无统计学意义(P>0.05)。

结论：玻璃体切除联合玻璃体腔注射康柏西普治疗PCV并发玻璃体积血疗效确切，且安全性较高。

METHODS: The clinical data of 59 patients(59 eyes)underwent vitrectomy in a hospital from May 2013 to August 2016 were retrospectively analyzed. Among them, 21 cases treated with vitrectomy were set as the control group; 38 cases treated with vitrectomy combined with intravitreal injection of conbercept were set up as the observation group. The efficacy and safety of the two groups were observed.

RESULTS: After the 12-month follow-up, the fundus examination of the observation group revealed that the deep, superficial retina hemorrhage and exudation of 38 patients were completely absorbed, and B-ultrasound showed that all patients with subretinal hemorrhage were also completely absorbed. However, B-ultrasound showed that subretinal hemorrhage and exudation still existed in 18 patients with varying degrees. The total BCVA changes before and after treatment in the two groups were statistically significant(P<0.01). After 1, 3, 6 and 12mo of treatment, the BCVA in the observation group was all significantly better than that in the control group, and the statistical difference between the groups was significant(P<0.05). After treatment, the changes of central retinal thickness(CRT)in the two groups were statistically different(P<0.01). After 1wk, 1, 3, 6 and 12mo of treatment, the CRT in the observation group was all significantly lower than that in the control group, and the statistical difference between the groups was significant(P<0.05). After 1wk of intravitreal Conbercept injection in observation group, the neovascularization of anterior chamber and iris of 37 cases completely subsided, only one case had a small residual neovascularization, the regression rate was 97%. After 1wk of vitrectomy in control group, the neovascularization of 16 cases subsided obviously with a regression rate of 76%. There was significant difference between groups(χ²=35.680, P<0.001). No serious complications were observed in the two groups during follow-up, and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: Vitrectomy combined with intravitreal injection of conbercept is an effective and safe way for PCV associated with vitreous hemorrhage.