Observing The Clinical Efficacy For Vitrectomy Combined With Postoperative Anti VEGG Drugs In The Treatment For Patients Of Polypoid Choroid Vascular Merge Vitreous Hemorrhage

Objective:In this paper,We provide reliable clinical treatment for patients of PCV merge VH by observing the clinical efficacy of the vitrectomy combined anti VEGF drugs.Methods:We collected 46 cases(47 eyes)patients with vitreous hemorrhage merge PCV and received 23 G Pars plana vitrectomy(PPV)between December 2013 and December 2013 doctor to our hospital.All patients were diagnosed with PCV after Indocyanine green angiography(ICGA)and Fundus fluorescein angiorgam(FFA)or Optical coherence tomography(OCT)previous or postoperative.All cases were divided into two groups:injection group and control group,according to whether underwent glass cavity injection of anti Vascular endothelial growth factor(VEGF)postoperative.Injection group of 29 eyes in postoperative 1 week,1 month,2 month were injected 0.5mg/0.05 ml Intravitreal ranibizumab(IVR)in glass cavity.Control group of 18 eyes underwent simple vitreous cut.The preoperative and postoperative visual acuity,the thickness of central fovea of retinal macula lutea and postoperative complications,retinal replacement and silicone oil replacement were compared between the two groups.Results:1.Vision:(1)the contrast between-subjects: The postoperative Best corrected visualacuity(BCVA)were compared between not involving macula lutea type PCV injection group and the control group.The differences of comparison of 1 month BCVA were statistically significant(P = 0.048),the others have no obvious statistical significance(P>0.05).The differences of comparison of 1 week and 1 month BCVA have no obvious statistical significance(P>0.05)among involving macula lutea type PCV injection group and the control group.But the comparison of 1 month?2 month?3month? 6month?12month were statistical significance(P<0.01).(2)the contrast within-group: Differences between two groups of postoperative and preoperative BCVA were statistically significant.2.Thickness of postoperative macular center concave retinal: The comparison of1 month macula Central retinal thickness(CRT)have obvious difference(P=0.003)among not involving macula lutea type PCV injection group and the control group.The comparison of 2 month has statistical significance(P=0.027).The comparison of1 month CRT has statistical significance(P=0.028)among involving macula lutea type PCV injection group and the control group.The comparison of 2 month ?3month?6month and 12 month have obvious difference(P<0.01).3.The postoperative complications: The differences of comparison of injection group and the control group about early postoperative vitreous body or anterior chamber hemorrhage were statistically significant(P=0.025).The differences of comparison of two groups about the postoperative retinal reposition were statistically significant(P=0.0023).The differences of postoperative intraocular pressure have no statistically significant(P=0.548).The differences of comparison of postoperative eye pigment meningitis have no statistically significant(P=0.550).Conclusion:1.Vitreous cavity injection of anti VEGF drugs assisted Pars plana vitrectomy(ppv)can effectively reduce the thickness of center concave retinal macular to the treatment of of PCV merge VH.It can improve the patients' vision better and reduce the occurrence of postoperative complications.2.The eventually prognosis is closely related to whether the lesions involving the macular and the scope of subretinal hemorrhage.