增殖型糖尿病视网膜病变玻璃体切割手术并发症及发生因素分析

The complication of vitrectomy in treatment of proliferative diabetic retinopathy

目的分析增殖型糖尿病视网膜病变(PDR)患者玻璃体切割手术的并发症,探讨其发生原因.方法 PDR患者42例48眼,行三切口闭合式玻璃体手术,术后随访6～40个月,观察手术并发症的发生率及发生原因.结果在42例48眼PDR玻璃体切割手术并发症中,发生医源性视网膜裂孔9眼(18.8%);玻璃体出血,术中6眼(12.5%),术后8眼(16.7%);角膜水肿10眼(20.8%);虹膜红变及新生血管性青光眼5眼(10.4%);视网膜脱离5眼(10.4%);并发白内障21眼(43.8%);视网膜中央动脉栓塞2眼(4.2%).结论 PDR手术并发症的发生主要与病变程度、手术技巧、术中术后是否正确彻底处理眼部每一个病灶有关.术中、术后正确处理眼部病变,同时术前、术后兼顾全身情况,可不同程度避免手术并发症的发生.

Objective To analyze the complications of vitrectomy in treatment of proliferative diabetic retinopathy. Methods 42 cases 48 eyes of PDR treated with vitrectomy were followed up 6～40 months,observing the intraoperative or postoperative complications. Results Among the complications of these cases,introgenic retina hole occured in 9 eyes(18.8%);intraoperative vitreous hemorrhage in 6 eyes(12.5%),postoperative vitreous hemorrhage in 8 eyes(16.7%);corneal edema in 10 eyes(20.8%);rubeosis iridis and neovascular glaucoma in 5 eyes(10.4%);retinal detachment in 5 eyes(10.4%);complicated cataract in 21eyes(43.8%)and CRAO in 2eyes(4.2%). Conclusions The main influencing factor were related with the severity of PDR;surgical skills and wether dealing with every pathological area correctly and thoroughly.Operating any pathological area correctly and noticing systemic status momently would reduce the complications to some degree.