The effect of Ranibizumab combined with trabeculectomy and Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma

Objective To investigate the clinical efficacy of intravitreal injection of ranibizumab combined with trabeculectomy and Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma. Methods The clinical data of 35 patients with 37 eyes of stage II ~ III 1 neovascular glaucoma who were treated in our hospital from October 2014 to March 2017 were analyzed retrospectively. All patients received intravitreal injection of r anibizumab. After 3~7d, they were divided into trabeculectomy group (group A, 16 eyes) and glaucoma valve implantation (B group, 21 eyes) according to surgical treatment. After 8~36 months of follow-ups, the intraocular pressure, the neovascularization of the iris, the change of vision and the incidence of complications were compared in the two groups. Results The intraocular pressure of the two groups after the injection and the different periods after the operation were significantly lower than that before the injection, and the difference was statistically significant (P < 0.01). There was no significant difference in intraocular pressure between the two groups at 1 weeks and 1 months after operation (t=-0.23, P=0.82, t=1.01, P=0.32), but the average intraocular pressure in the B group was lower than that in the A group at 6 months and at the last follow-up period (t=3.03, P=0.005, t=2.51, p=0.02). In the two groups, the neovessels of iris partially or all disappeared after 3~7d injection, and the effective rate was 100%. There was no significant difference in visual acuity between the two groups after operation (x 2=1.67, P=0.20). There was no significant difference in the incidence of postoperative complications between the two groups (x 2=0.64, P=0.42). Conclusion Compared with trabeculectomy, intravitreal injection of r anibizumab combined with glaucoma drainage valve implantation can control intraocular pressure in a more sustainable way