摘要
目的评价玻璃体切除联合白内障手术治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的临床效果。方法回顾性分析了2005年7月至2009年12月在我院行玻璃体切除联合白内障手术的PDR患者48例(52眼),术后随访7个月以上,统计分析手术方式、术前、术后最终矫正视力、手术并发症等临床资料。结果硅油填充率随着糖尿病眼底病变发展而增加,VI期硅油填充率分别与IV期、V期相比差异显著,P<0.01;随访期间,71.15%(37/52)术后视力提高,随着糖尿病眼底病变发展,术后视力提高率下降,IV、V、VI期术后视力提高率分别是100%、92.31%和62.16%,但各组间无显著差异,P>0.05,其中视力0.1以上的眼数由术前的5眼(11.36%)增加到术后的33眼(75%),术后视力显著好于术前,P<0.01;一次性视网膜复位成功率100%。1眼术后玻璃体再次出血,7眼发生后发性白内障,硅油填充组6眼术后早期发生高眼压,4眼在术后不同时期发生硅油乳化。结论玻璃体切除联合白内障手术治疗PDR是安全有效的,有利于早期恢复患者视力,避免再次白内障手术。
Objective To evaluate the outcome of vitrectomy combined with cataract surgery for proliferative diabetic retinopathy（PDR）.Methods Totally 52 eyes of 48 PDR patients underwent vitrectomy combined with cataract surgery from July 2005 to December 2009 were retrospectively analyzed.Surgery procedure,preoperative and postoperative best corrected visual acuity and complication were retrospectively analyzed.The follow-up lasted for more than seven months.Results Silicon oil injection rate increased with the progression of PDR stage.Silicon oil injection rate in stage VI were significantly higher than that in stage IV and V（P0.01）.During the follow-up,71.15%（37/52 eyes） showed improved visual acuity postoperatively.The postoperative visual acuity improve rate decreased with the progression of PDR（100% in stage IV,92.31% in stage V and 62.16% in stage VI） and there was no significant difference among different stages（P0.05）.The number of eyes with visual acuity better than 0.1 were increased from 5（11.36%） before operation to 33（75%） postoperatively.Postoperative visual acuity improved significantly compared with that before operation.（P0.01）.All eyes（100%） showed anatomic repair of retinal detachment after the surgery.Vitreous hemorrhage was found in one eye,after-cataract was found in seven eyes post combined operation.High intraocular pressure was found in six eyes,silicon oil emulsification was found in four eyes in silicon oil injection group.Conclusion Vitrectomy combined with cataract surgery is safe and effective in treating patients with PDR.Combined surgery may avoid a second operation for patients with cataract and provide earlier visual rehabilitation.
出处
《局解手术学杂志》
2010年第5期387-389,共3页
Journal of Regional Anatomy and Operative Surgery
