玻璃体切割联合曲安奈德球内注射治疗增殖性糖尿病视网膜病变

Triamcinolone Acetonide Assisted Pars Plana Vitrectomy for the Treatment of Proliferative Diabetic Retinopathy

目的:探讨玻璃体切割联合曲安奈德球内注射治疗增殖性糖尿病视网膜病变的优点和并发症。方法:对32例患者34只眼具有玻璃体积血的增殖性糖尿病视网膜病变眼行玻璃体切割联合曲安奈德球内注射。结果:(1)炎症反应程度:所有施行手术眼中,只有11只眼(32.35%)发生短期的房水闪辉;(2)视力改善情况:29只眼(85.29%)手术后视力较手术前提高超过2行,5只眼(14.71%)手术后视力较术前没有改善;(3)眼压变化:术后2周内的眼压较手术前高,有9只眼(26.47%)发生一过性的高眼压,术后第3月的眼压与术前比较,其差异经统计学分析没有显著性;(4)全身情况:术前和术后全身血糖和血压的比较,其差异没有显著性。结论:玻璃体切割联合曲安奈德球内注射在控制增殖性糖尿病视网膜病变的炎症反应有较好的效果,临床上没有严重的并发症。

Objective： To study the advantages and complications of triamcinolone acetonide （TA） assisted pars plana vitrectomy （PPV） for the treatment of proliferative diabetic retinopathy （PDR）. Methods： The study included 32 patients 34 eyes who underwent PPV for the treatment of PDR, who received an intravitreal injection of 5 mg crystalline triamcinolone acetonide at the end of surgery. Results： Intraocular inflammation was low. The postoperative visual acuity was improved in 29 eyes. The difference between the mean preoperative and postoperative intraocular pressure after 3rd month postoperatively was statistically significant. But the difference was not statistically significant at the end of follow up time. The postoperative blood sugar and pressure showed no significant difference from preoperative values. No retinal toxicity was found in any eye. Conclusion： Triamcinolone acetonide assisted PPV for PDR was useful to reduce postoperative intraocular inflammation with no serious complications.