| Objective: To investigate the clinical efficacy of anti-VEGF drugs combined with23 G vitrectomy in the treatment of neovascular glaucoma with diabetic retinopathy.Methods: Clinical case data of patients with diabetic retinopathy secondary to neovascular glaucoma(PDR-NVG)attending The First Hospital of Dalian Medical University between March 2021 and August 2022 were collected.23 cases(26 eyes)were included in the study according to the inclusion criteria,which were reviewed and approved by the ethics committee of The First Hospital of Dalian Medical University,and all patients signed an informed consent form.23 cases(26 eyes)were diagnosed by 2 experienced ophthalmologists together.All 23 patients(26 eyes)were diagnosed by two experienced ophthalmologists as having neovascular glaucoma caused by diabetic retinopathy with atrial or iris neovascularization and varying degrees of IOP elevation.23 patients(26 eyes)were examined preoperatively for visual acuity(BCVA),IOP,slit lamp microscopy,anterior chamber angioscopy,ocular ultrasound,OCT,and fundus photography.All patients were operated by the same experienced ophthalmologist during their hospitalization in our hospital.The surgical approach was as follows: vitreous cavity injection of anti-VEGF drugs was performed first,23 G vitrectomy was performed 2-7 days after the injection,C3F6 inert gas or silicone oil filled surgery was selected by the operator in combination with the fundus retinal condition,and adequate whole retinal laser photocoagulation was performed intraoperatively.The regression of iris neovascularization,IOP,visual acuity,and postoperative complications were analyzed before treatment,1 day,1 week,1 month,and 3 months after treatment.SPSS 26.0 software was used for statistical analysis of the data,and P < 0.05 was statistically different.Results: The IOPs of the PDR-NVG patients were(42.54±18.80)mm Hg,(20.27±8.56)mm Hg,(19.96±7.32)mm Hg,(25.15±13.72)mm Hg,and(26.92±12.49)mm Hg before and 1 day,1 week,1 month,and 3 months after surgery,respectively,and 1 day,1 The IOP at 1 day,1 week,1 month and 3 months after surgery was significantly lower than the preoperative IOP,and the difference was statistically significant(P < 0.001).The difference was statistically significant(P < 0.05),with a significant decrease in IOP at 1 month postoperatively compared with 1 week postoperatively.At 1 day,1 week,1 month,and 3 months postoperatively,iris neovascularization was significantly regressed compared to preoperatively,and the difference was statistically significant(P < 0.001).There was no statistically significant difference in visual acuity at 1 day,1 week,1 month,and 3 months postoperatively compared with preoperatively(P > 0.05).Conclusion: Intravitreal injection of anti-VEGF drugs combined with 23 G vitrectomy treatment can effectively reduce IOP in patients with diabetic retinopathy secondary to neovascular glaucoma,and has a good regressive effect on neovascularization. |
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