目的：探讨玻璃体腔注射康柏西普后对新生血管性青光眼(NVG)患者房水中VEGF、IL-6、IL-8的影响，并观察其联合不同手术方式对NVG患者的疗效。方法：选择2019-01/2020-02在中国人民解放军新疆军区总医院全军眼科中心就诊的NVG患者102例，均玻璃体腔注射康柏西普，3～5d后行手术治疗，按照随机数字抽签法分为小梁切除术组(50例50眼)及EX-PRESS引流器植入术组(52例52眼)，运用酶联免疫吸附法分析房水中VEGF、IL-6、IL-8的变化情况，观察虹膜新生血管消退情况，比较两组手术疗效及术后眼压变化、视力改善情况及并发症发生情况。结果：玻璃体腔注射康柏西普3～5d后房水中VEGF、IL-6、IL-8表达水平较术前降低(均P<0.05)； 术后随访各时间点两组眼压水平均显著低于术前(均P<0.05)，两组患者眼压在术后3、6、12mo组间比较有差异(均P<0.05)； 术后6、12mo时EX-PRESS组视力优于小梁切除术组(P<0.05)； 术后12mo，两组使用抗青光眼药物种类及数量无明显差异(均P>0.05)； 随访12mo，EX-PRESS组患者手术成功率(86.5%)优于小梁切除术组(70.0%)，且EX-PRESS组术后并发症发生率显著低于小梁切除术组(P<0.05)。结论：玻璃体腔注射康柏西普后可以降低NVG患者房水中VEGF、IL-6、IL-8等因子表达，同时小梁切除术与EX-PRESS引流器植入术均可降低NVG患者眼压，但后者手术并发症较少、改善视力方面更有优势。

AIM: To investigate the impact of intravitreal conbercept injection on the aqueous humor levels of vascular endothelial growth factor(VEGF), interleukin-6(IL-6)and interleukin-8(IL-8)in patients diagnosed with neovascular glaucoma(NVG), and to evaluate the efficacy of conbercept in combination with different surgical modalities.METHODS: This study was conducted as a retrospective, case series investigation. A total of 102 patients(102 eyes)diagnosed with NVG from Jan. 2019 to Feb. 2020 were enrolled and randomized to trabeculectomy group(50 eyes of 50 cases)or EX-PRESS drain implantation group(52 eyes of 52 cases)3-5d after conbercept injections. The concentrations of VEGF, IL-6 and IL-8 in aqueous humor were determined by enzyme-linked immunosorbent assay(ELISA). The therapeutic efficacies of different surgical modalities were evaluated and compared by status of iris neovascularization, changes in postoperative intraocular pressure(IOP), improvement of visual acuity and incidence of complications.RESULTS:Decreases in aqueous humor concentrations of VEGF, IL-6 and IL-8 were observed at 3-5d after treatment of conbercept(all P<0.05). At 1, 3d, 1, 3, 6 and 12mo after surgery, the IOP levels of patients in both groups were significantly reduced compared to those before surgery(all P<0.05), and there was a statistically significant difference in IOP between the two groups at 3, 6, and 12mo postoperatively(all P<0.05). At 6 and 12mo after surgery, patients treated with EX-PRESS drain implantation showed better visual acuity compared to patients treated with trabeculectomy(all P<0.05). There was no statistically significant difference in types and dosages of anti-glaucoma drugs administered to patients in different groups. At 12mo follow-up, success rate of surgery in the EX-PRESS drain implantation group(86.5%)was higher than that in the trabeculectomy group(70.0%), along with remarkably lower incidence rate of complications compared to that of the trabeculectomy group(P<0.05).CONCLUSION: The intravitreal injection of conbercept could down-regulate aqueous humor concentrations of VEGF, IL-6 and IL-8. Both of trabeculectomy and EX-PRESS drain implantation could reduce IOP in NVG patients, but the latter procedure had fewer incidence of complications and was more advantageous in improving visual acuity.

新疆军区总医院北京路医疗区青年培育科研项目(No.2020jzbj1009)