Kobayashi Satoshi, Inoue Maiko, Yamane Shin, Sakamaki Kentaro, Arakawa Akira, Kadonosono Kazuaki
*Department of Ophthalmology, Yokohama Hodogaya Central Hospital Departments of †Ophthalmology ‡Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan.
J Glaucoma. 2016 Mar;25(3):281-4. doi: 10.1097/IJG.0000000000000211.
To evaluate the long-term (>3 y) outcomes of patients given preoperative intravitreal bevacizumab (IVB) injection before trabeculectomy for neovascular glaucoma (NVG).
We performed a retrospective study of a consecutive series of 12 eyes of 11 patients who underwent trabeculectomy with mitomycin C combined with preoperative IVB for NVG at our institution between April 2009 and April 2010. The mean follow-up period was 43.0±7.0 months (range, 36 to 51 mo), and all patients were followed up for at least 36 months. Surgical success was defined as an intraocular pressure (IOP) of ≤21 mm Hg with or without topical ocular hypotensive medication.
The cumulative surgical success rate was 83.3% at 1 year and 83.3% at 3 years. The mean IOP before surgery was 42.7±9.2 mm Hg, whereas the mean postoperative IOP was significantly lower, being 15.1±3.7 mm Hg at 1 year and 14.2±3.2 mm Hg at 3 years (P<0.01).In contrast, no significant change of the mean visual acuity as compared with the preoperative visual acuity was observed at the follow-up carried out 3 years after the surgery. Intraoperative and early postoperative hyphema was seen in 2 eyes. Recurrence of neovascularization requiring additional IVB injection was seen in 3 eyes.
Preoperative IVB injection before trabeculectomy for NVG might be effective over the long-term (>3 y) control of the IOP.
评估在小梁切除术前行玻璃体内注射贝伐单抗（IVB）治疗新生血管性青光眼（NVG）患者的长期（>3年）疗效。
我们对2009年4月至2010年4月期间在我院接受丝裂霉素C小梁切除术联合术前IVB治疗NVG的11例患者的12只眼睛进行了一项回顾性研究。平均随访期为43.0±7.0个月（范围36至51个月），所有患者均随访至少36个月。手术成功定义为眼压（IOP）≤21 mmHg，无论是否使用局部降眼压药物。
1年时累积手术成功率为83.3%，3年时为83.3%。术前平均IOP为42.7±9.2 mmHg，而术后平均IOP显著降低，1年时为15.1±3.7 mmHg，3年时为14.2±3.2 mmHg（P<0.01）。相比之下，术后3年随访时，与术前视力相比，平均视力无显著变化。2只眼睛出现术中及术后早期前房积血。3只眼睛出现新生血管复发，需要再次注射IVB。
小梁切除术治疗NVG术前注射IVB可能对长期（>3年）控制眼压有效。
