乌云+其其格+杨亮

【摘要】目的观察两种不同术式治疗增生性糖尿病视网膜病变(PDR)的疗效。方法具有玻璃体手术指征的PDR 48例(51眼)纳入研究, 所有患者均行视力、裂隙灯、间接检眼镜、眼B超、角膜曲率和人工晶体度数等检查。回顾性分析26例(27眼)行单纯玻璃体切除术和22例(24眼)行联合超声乳化术治疗的PDR患者。平均随访时间分别为14个月和8个月。结果单纯玻璃体切除组有13眼视力≥0.4(48.1%), 联合手术组有6眼视力≥0.4(25.0%)；单纯玻璃体切除组有1眼出现前房炎症反应, 联合手术组有5眼出现前房纤维素渗出；单纯玻璃体切除组有13眼出现白内障, 联合手术组有6眼出现后发性白内障(后发障)。结论单纯玻璃体切除组手术时间短, 术后反应轻, 术后视力较好；联合手术组手术时间长, 术后反应重, 但避免再次手术, 远期效果好。

【关键词】糖尿病性视网膜病变；玻璃体切除术；超声乳化术

Curative effect of vitrectomy alone and vitrectomy combined with phacoemulsification onproliferative diabetic retinopathy WU Yun, QI Qi-ge, YANG Liang. Department of Ophthalmology, Hulunbuir People's Hospital, Hulunbuir 021008, China

【Abstract】Objective To observe the efficacy of different surgical methods on proliferative diabetic retinopathy(PDR). Methods Vitrectomy was undergone in forty-eight cases(51 eyes)with PDR.All patients were identified visual acuity, slit lamp, indirect ophthalmoscopy, eye B ultrasound, corneal refractive power and intraocular lens power. 26 patients(27eyes)who underwent vitrectomy alone and 22 patients(24eyes)who underwent vitrectomy combined with phacoemulsification were retrospectively analyzed. The average follow-up was 14 months and 8 months respectively. Results The visual acuity of 13 eyes(48.1%) in vitrectomy alone group ≥0.4, while only 6 eyes(25.0%) in combined vitrectomy group; one eyes was found postoperative fibrin formation in vitrectomy alone group, while five eyes in combined vitrectomy group; 13 eyes were found postoperative cataract in vitrectomy alone group, while 6 eyes were found posterior capsular opacity in combined vitrectomy group. Conclusion Vitrectomy alone group with shorter operative time, shorter reation, and better visual acuity; combined vitrectomy group with longer operative time, higher reation, better long-term effect, but avoiding reoperation.

【Key words】Diabetic retinopathy; Vitrectomy; Phacoemulsification玻璃体切除术治疗增生性糖尿病视膜病变(proliferatived diabetic retinopaty, PDR), 手术难度大, 手术时间长, 术后效果差, 手术方式的选择根据糖尿病性视网膜病变严重程度及晶体混浊情况决定。单纯玻璃体切除术具有手术时间短, 术后视力好等优点。联合白内障超声乳化组术后反应重, 手术难度大, 但可避免行二次白内障手术, 术后易补激光观察眼底等优点。对比两组患者优点及缺点, 临床上根据病情选择手术方式。

1资料与方法

1. 1一般资料将2010年6月~2012年6月本院收治的PDR 48例51眼纳入研究。所有患者糖尿病性视网膜病变均为增殖期, 均玻璃体血性混浊, 视网膜前新生血管, 视盘新生血管, 部分累及后极或牵拉视网膜脱离, 牵拉孔源性视网膜脱离等。……