Avastin在增生性糖尿病性视网膜病变玻璃体切割手术中的临床应用

Clinical application of Avastin in the surgery of proliferative diabetic retinopathy

目的探讨Avastin在增生性糖尿病性视网膜病变(PDR)玻璃体切割手术中应用的临床效果。方法回顾分析31例(32眼)PDR患者,术前5～7d玻璃体腔内注射Avastin 0.1 mL/2.5 mg,行标准的三通道玻璃体切割手术,其中合并白内障的患者同时一期行超声乳化+人工晶体植入术。结果术中发现术前活跃的新生血管膜明显消退,术中出血明显减少,且膜剥除难度明显降低。随访3个月,26例26眼(81.3%)矫正视力较术前明显提高,4例5眼(15.6%)无明显变化,1例1眼(3.1%)视力反而下降。无严重并发症。结论Avastin可以显著降低PDR玻璃体切割手术的难度,减少术中出血,缩短手术时间,改善患者视力。但其安全性和有效性需长期大样本的临床观察。

Objective To evaluate the clinical effect of Avastin on vitrectomy for proliferative diabetic retinopathy（PDR）. Methods The clinical data were retrospectively analyzed in 32 eyes of 31 patients for PDR treated with an intravitreal injection of 0.1 mL/2.5 mg Avastin 5-7 days before the operation, then a normal three-way vitreetomy was made on all the patients, and phacoemulsifieation and intraocular lens implantation were combined for 16 patients with cataraet. Results Originally active neovascularization decreased or ended, hemorrhage decreased in stripping and cutting the membrane, and stripping the membrane became easier than before. In a follow up of 3 months, visual acuity increased in 26 eyes（ 81.3 % ）, was unchanged in 5 eyes （ 15.6% ）, and decreased in 1 eye（3.1% ）. No severe eomplieations were found. Conclusion Avastin can significantly make vitreetomy easy, reduce the risks of hemorrhage and improve visual acuity of patients, but the safety and availability need a longterm and large sample clinical observation.