抗新生血管药物联合玻璃体切割视网膜复位术治疗严重增殖性糖尿病视网膜病变观察

Pars Plana Vitrectomy Assisted by Bevecizumab(Avastin) for Proliferative Diabetic Retinopathy

目的探讨抗新生血管药物联合玻璃体切割视网膜复位术治疗严重增殖性糖尿病视网膜病变(PDR)的临床应用价值。方法回顾性分析严重增殖性糖尿病视网膜病变Ⅵ期患病者42例50眼,均于术前10～14d行Bevacizumab(Avastin)1.25mg/0.05ml玻璃体腔注射,而后联合玻璃体切割视网膜复位术并眼内填充硅油或惰性气体。结果50眼术后视网膜解剖全部复位,术中出血较少。所有病例术后验证反应较轻,眼压控制良好,眼内留置硅油无明显并发症。结论抗新生血管药物联合玻璃体切割视网膜复位治疗严重增殖性糖尿病视网膜病变能够明显减少术中出血,减少术后并发症,提高患者术后最佳矫正视力。

Objective To evaluate the efficacy of vitrectomy with preoperative intravitreal injection of Bavacizumab （Avastin）for severe proliferative diabetic retinopathy. Methods 42 cases （50 eyes ）with severe proliferative diabetis retinopathy treatment by vitrectomy with preoperative intravitreal injection of Bevacizumab （Avastin）were analyzed retrospectively. 10-14 days before vitrectomy, intravitreal injection of Bevacizumab （Avastin）1.25mg/0. 05ml was performed on all 50 eyes. 7 eyes with traction retinal detachment and severe macular edema were tamponed with silicon iol. 43 eyes with regional tractional retinal detachment and retinal hole were tamponed with gas. Results 50 eyes had little hemorrhage during vitrectomy with intravitreal injection of Bevacizumab （Avastin）. The retinal are all reattatched after the operation. No more severe inflammatory reaction occured after vitrectomy. The intraocular pressure was under controlled. And there were no side effect in oil eyes. Conclusion Intravitreal injection of Bavacizumab （Avastin） 10-14 days before vitrectomy for severe proliferative diabetic retinopathy can reduce the risk of hemorrhage during the operation and complication after the operation and improve the corrective eyesight after the operation.