增殖性糖尿病性视网膜病变玻璃体手术的预后分析

Analysis of prognosis of vitrectomy in proliferative diabetic retinopathy

为探讨可能影响手术预后的各种因素及其与手术预后的关系，以指导手术时机和适应证的选择，降低手术并发症，为提高手术成功率提供依据。回顾性分析了２６只增殖性糖尿病性视网膜病变（ＰＤＲ）眼行玻璃体手术的临床资料。结果：２６眼中功能恢复１８眼（６９．２％），解剖复位３眼（１１．５％），失败５眼（１９．２％）。手术预后与玻璃体出血时间长短、患者年龄有关，与糖尿病类型、眼底病变程度（Ⅴ、Ⅵ两期）、性别、有无裂孔及术中激光治疗等因素无关（Ｐ＞０．０５）。结论：对年轻患者行玻璃体手术应慎重；ｌ型糖尿病眼宜早期手术，Ⅱ型糖尿病眼宜延期手术（一年以上），可能有助于降低手术并发症，改善手术预后。

o find out factors which may influence the Prognosis of pars plana vitrectomy (PPV), to guide the occaslons and indications and to reduce complications and improve success rate,the clinical data of 26 eyes with proliferative diabetic retinopathy(PDR) undergone PPV were analyzed retrospetcively.results:functional recovery was achieved in 18 eyes (692%),anatomic recovery in 3 eyes (115%), 5 of 26 eyes failed (192%). The prognosis of PPV was related to the time between vitreous hemorrhage and operation、the age of patients, but was not related with types of diabetes、degree of diabetic retinopathy (stage Vand Ⅵ)、sex of patients. existance of retina tears and laser photocoagulation (P>005). conclusion: Our results suggest that PPV for the young patients with PDR should be considered carefully. Early PPV for the eyes with type I diabetes, deferal PPV (at least 1 year) for type Ⅱ diabetes, may be helpful to reduce the complications and improve the prognosis.