摘要
目的:探讨超声乳化联合玻璃体切除和后路晶体切除术联合玻璃体切除两种手术方式在白内障合并增生性糖尿病视网膜病变(PDR)治疗中的临床疗效。方法:分析79例PDR,共100眼,随机分为2组,术式1组53只眼,为白内障超声乳化术后,行闭合式三通道玻璃体切除,囊袋内植入后房型人工晶体;术式2组47只眼,为经扁平部玻璃体联合晶体切除术,保留前囊,人工晶体植入前囊上、睫状体沟内。结果:术后随访3个月～2年,术式1组视力改善41只眼,占77.36%;术式2组视力改善30只眼,占63.83%,两组术后视力改善眼数比较差异有统计学意义(χ2=4.76,P<0.05)。术式1组术后发生虹膜新生血管(INV)1只眼,占1.8%;术式2组术后发生INV7只眼,占14.9%,两组术后INV发生率差异有统计学意义(χ2=5.84,P<0.05)。结论:在治疗白内障合并PDR患者中,术式1组优于术式2组,其术后并发症和INV的发生率也明显低,可使大多数患者的视力改善。
Objective： To investigate the efficacy of phacoemulsification or pars plana lensectomy combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract. Methods： Seventy-nine cases （100eyes） with PDR and cataract who were undergone two different combined surgery from May 2003 to Dec 2006 in our hospital were reviewed, the cases were divided into two groups. Groupl was treated with the techniques included phacoemulsification. Combined vitrectomy in 53 eyes, IOL was inserted into the introcapsule via the corneascleral incision. Group 2 was treated with the techniques of lensectomy via the pars plana combined posterior segment surgeries in 47eyes, the anterior capsule was preserved and the epithelium was suctioned and scraped off, IOL was inserted via the corneascleral incision on the anterior capsule, of which the center area 4.5-5 mm in diameter was cut. Results： Seventy-nine cases including 100 eyes after surgery were followed-up for 2 months to 3 years. Postoperatively, There were significanted differences between two groups. In visual improvement which was achieved in 41 eyes （77.36%） in group 1, in 31 eyes （63.83%） in group 2. There were significant difference between, two, groupsin, visual, improvement （x^2=4.76, P 〈0.05）. Iris neovascularizati-on （INV） occurred in one eye in group 1 （1.8%） and 7 eyes in group 2（14.9%） during 1.5-11 months. After, surgery （x^2 =5.84, P 〈0.05）. Conclusions： Phacoemusification and simultaneous introcapsule lens implantation combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract is more effective than pars plana lensectomy combined with vitrectomy. The surgery obviously improves the visual outcome in the majority of selected eyes with less significant complications and less iris neovascularization （INV）.
出处
《新疆医科大学学报》
CAS
2007年第9期981-984,共4页
Journal of Xinjiang Medical University
