目的：评价玻璃体腔注射(IVR)雷珠单抗联合全视网膜光凝(PRP)术后行传统小梁切除手术治疗新生血管性青光眼的有效性及安全性。

方法：回顾性分析2015/08～2018/11在我院收治的27例27眼新生血管性青光眼(NVG)患者的病例资料。所有患眼均在接受IVR联合PRP治疗后，再行传统小梁切除手术。主要观察指标为眼压(IOP)控制情况、最佳矫正视力(BCVA)变化以及手术并发症。

结果：术后随访时间至少18(平均21.7±4.3)mo。末次随访时，平均IOP由治疗前的45.7±5.1mmHg下降至18.4±3.6mmHg，BCVA(LogMAR)由治疗前2.42±0.68提高至1.77±0.93。术后3mo至末次随访，周边虹膜前粘连(PAS)≤50%的患眼手术成功率高于PAS>50%的患眼。主要的并发症包括术后早期发生的前房积血(11.1%)、低眼压伴浅前房(14.8%)，以及术后中、晚期发生的滤过泡包裹(37.0%)。未观察到严重的术中和术后并发症。

结论：IVR联合PRP术后进行传统小梁切除手术治疗NVG安全有效，特别适用于PAS≤50%的患眼。术前进行IVR和PRP治疗有助于提高小梁切除手术的成功率。

METHODS: The charts of 27 patients(27 eyes)who presented with NVG in our hospital between August 2015 and November 2018 were reviewed. All eyes were treated using the standard protocol of IVR accompanied by PRP, followed by conventional trabeculectomy without drainage device. The main outcomes were intraocular pressure(IOP)control, change in best-corrected visual acuity(BCVA), and surgical complications.

RESULTS: The postoperative follow-up periods for all patients were at least 18(mean 21.7±4.3)mo. The IOP significantly decreased from 45.7±5.1 mmHg(baseline)to 18.4±3.6 mmHg(last visit), and BCVA(LogMAR)improved from 2.42±0.68(baseline)to 1.77±0.93(last visit). The success rate was higher in eyes with peripheral anterior synechiae(PAS)≤50% than in those with PAS >50% after 3mo postoperatively. The main surgical complications were hyphema(11.1%)and hypotony with a shallow anterior chamber(14.8%)during the early postoperative stage, along with encapsulated bleb(37.0%)during the mid-late postoperative stage. Serious intraoperative or postoperative complications were not observed.

CONCLUSION: IVR and PRP combined with conventional trabeculectomy without drainage device is a safe and effective way in NVG treatment, especially for eyes with PAS ≤50%. Preoperative IVR and PRP appear to improve the success rate.