Comparison of efficacy of Ex-press implantation combined with intravitreal leizumab injection and Ex-press implantation combined with mitomycin C in the treatment of complicated glaucoma

Abstract

Objective To investigate the efficacy of Ex-press implantation combined with intravitreal leizumab injection and Ex-press implantation combined with mitomycin C in the treatment of complicated glaucoma. Methods The 26 cases of refractory glaucoma patients(30 eyes) were selected from January to August 2018.The patients were randomly divided into the leizumab group and mitomycin C group.Each group had 15 eyes(patients with binocular diseases were included in the same group). In the leizumab group, 4 males(5 eyes) and 8 females(10 eyes) were aged(58.6±8.7) years old, ranging from 45 to 76 years old.In mitomycin group C, 6 males(7 eyes) and 8 females(8 eyes) were aged(54.2±11.8) years old, ranging from 43 to 76 years old.Patients in the leizumab group received Ex-press implantation combined with intravitreal injection of leizumab, while patients in the mitomycin C group received Ex-press implantation combined with mitomycin C. The visual acuity, intraocular pressure and medication status of patients in the two groups were compared 1 day, 1 week, 1 month, 3 months and 6 months after surgery. Results The visual acuity of the leizumab group was slightly higher at 1 day(0.44±0.09), 1 week(0.44±0.17), 1 month(0.43±0.07), 3 months(0.41±0.10) and 6 months(0.42±0.08) than that of the mitomycin C group[(0.36±0.11), (0.37±0.14), (0.35±0.08), (0.33±0.05) and(0.30±0.12)], with statistically significant differences(P<0.05). One day after surgery, the leizumab group[(12.15±3.52) mmHg, 1 mmHg=0.133 kPa] intraocular pressure at 1 week[(12.96±5.52) mmHg], 1 month[(13.32±3.74) mmHg], 3 months[(14.31±4.02) mmHg] and 6 months[(15.85±4.35) mmHg] was significantly lower than that in the mmHg group[(16.72±6.33)mmHg, (17.02±5.51)mmHg, (17.71±4.15)mmHg, (18.58±6.40)mmHg and(19.67±6.13)mmHg, with statistically significant differences(P<0.05). The types of lop drugs used in the leizumab group were less than those used in the mitomycin C group(0.42±0.37), (0.61±0.55) and(0.71±0.69) 1 month after surgery(0.33±0.29), 3 months(0.31±0.41) and 6 months(0.30±0.44), with statistically significant differences(P<0.05). Conclusion The efficacy of Ex-press implantation combined with intravitreal injection of tear-drop monoclonal antibody in the treatment of complicated glaucoma is better than Ex-press implantation combined with mitomycin C, which is worthy of clinical promotion and application. Key words: Ex-press implantation; Ranibizumab; Mitomycin C; Refractory glaucoma