Effect Of Anti-Vegf Combined Cyclophotocoagulation Through Minimally Invasive Incision In Neovascular Glaucoma

Objective:To observe and analyze the clinical effect and safety of the injection of anti-vascular endothelial growth factor(anti-VEGF)combined cyclophotocoagulation through 23 G minimally invasive scleral incision in the treatment of neovascular glaucoma.Methods:This was a prospective random control study,47 inpatients(47 eyes)were diagnosed neovascular glaucoma(NVG)and received treatment during January 2017 to June 2018 were collected.According to the surgical method,47 eyes were divided into two group:cyclophotocoagulation(group 1)and trabeculectomy(group 2).All eyes were underwent intravitreal injection of anti-VEGF(Conbervept 0.05ml)3days before surgery,and two groups combined with pars plana vitrectomy(PPV),phacoemulsification and panretinal photocoagulation(PRP).The follow-up period was 6 month.Observed and recorded the preoperative intraocular pressure(IOP),best corrected visual acuity(BCVA),iris neovascularization(IN),complications and the use of anti-glaucoma drugs in the two groups and compared with postoperatively at 1d,3d,1w,1mo,3mo and 6mo.Results:1.There were no significant differences between the preoperative and postoperative BCVA(P>0.05).2.There were no significant differences in the regression of IN between the two groups preoperative and postoperative(P>0.05),but there was statistically significant differences in the regression of IN between the two groups after surgery compared with preoperative(P<0.05).3.The postoperative complications was not significantly different between the group 1 and group 2(P>0.05).4.There was no significant differences in preoperative IOP between the two groups(P>0.05),and there was statistically significant differences in IOP in the two groups at 1d,3d,1w,1mo and 3mo after surgery compared with preoperative(P<0.05),both types of surgery can reduce IOP in the short term.The IOP of the group 1 was(18.29±7.02)mmHg at 6 mo,compared with the group 2(23.46±8.54)mmHg were significantly different(P<0.05),but no significant difference at 1d,3d,1w,1mo and 3mo(P>0.05).5.The difference in the use of anti-glaucoma drugs postoperative in the two groups was statistically significant compared with that before surgery(P<0.05).There was no statistically significant difference in the number of antiglaucoma drugs used postoperative between the two groups(P>0.05).Conclusions: 1.The methods of the injection of anti-VEGF drugs combining with minimally invasive incision cyclophotocoagulation is a safe and effective operation for the treatment of NVG.2.Both minimally invasive incision cyclophotocoagulation and trabeculectomy are effective methods for the treatment of NVG.There are no significant differences in both methods early,but the long-term outcomes of cyclophotocoagulation is better than trabeculectomy.3.Minimally invasive incision cyclophotocoagulation has the significant advantages of accurate location,controlling easily,recover quickly,having the smaller incision and conveniently appling to clinic.