超声睫状体成形术联合抗VEGF+全视网膜光凝术治疗晚期新生血管性青光眼OACSTPCD

AIM:To evaluate the safety and efficacy of ultrasonic cycloplasty(UCP)combined with anti-vascular endothelial growth factor(VEGF)+panretinal photocoagulation(PRP)in the treatment of advanced neovascular glaucoma(NVG). METHODS:Retrospective study.A total of 45 patients(45 eyes)with advanced NVG who received surgery in our hospital from August 2020 to September 2022 were collected and divided into UCP+anti-VEGF+PRP group(16 patients,16 eyes),transscleral cyclophotocoagulation(TCP)+anti-VEGF+PRP group(20 patients,20 eyes),UCP alone group(9 patients,9 eyes).The intraocular pressure,pain scores,postoperative medication,effective rate,total success rate and the incidence of complications of the patients in the three groups were compared before surgery and at 1 d,1 wk,1 and 3 mo after surgery. RESULTS:There was no significant difference in preoperative intraocular pressure,pain scores and preoperative medication of patients in the three groups(all P＞0.05).While there were statistical significance in the intraocular pressure and pain scores at 1 d,1 wk,1 and 3 mo after surgery(all P＜0.01).The intraocular pressure of the UCP alone group(31.78±10.23 mmHg)was found to be higher than that of both the UCP+anti-VEGF+PRP group(19.44±8.23 mmHg)and the TCP+anti-VEGF+PRP group(20.80±10.27 mmHg)at 1 mo postoperatively(all P＜0.017).The pain score of the TCP+anti-VEGF+PRP group at 1 d and 1 wk postoperatively was higher than both the UCP+anti-VEGF+PRP group and the UCP alone group(all P＜0.017).The effective rates of UCP+anti-VEGF+PRP group,TCP+anti-VEGF+PRP group and UCP alone group were 81％(13/16),75％(15/20)and 67％(6/9),respectively,(P=0.675),and the success rates were 69％(11/16),50％(10/20),and 0(0/9),respectively(P=0.003).There was no significant difference in complications of patients in the three groups(P＞0.05). CONCLUSION:UCP combined with anti-VEGF+PRP and TCP combined with anti-VEGF+PRP showed comparable efficacy in reducing intraocular pressure in advanced NVG.UCP combined with anti-VEGF+PRP was more effective in relieving pain and with no serious complications in advanced NVG.UCP alone can effectively control intraocular pressure and alleviate the pain of patients in the early postoperative period,but long-term control still requires anti-VEGF+PRP.