非接触式全视野镜在增生性糖尿病视网膜病变玻璃体术中的应用

Noncontact panoramic viewing systems for vitrectomy of late proliferative diabetic retinopathy

目的评价在非接触式全视野镜下进行玻璃体手术治疗严重增生性糖尿病视网膜病变的疗效。方法回顾44例（57只眼）严重增生性糖尿病视网膜病变在非接触式全视野镜下完成玻璃体手术的临床资料。结果术后随访了12。90月，平均58月，51只眼（90％）视网膜完全在位，36只眼（63％）视力不同程度提高，29只眼视力〉0．1。V期病变的23只眼中18只眼（78％）和Ⅵ期病变的34只眼中18只眼（52％）视力提高，两者差异有显著性意义（Х^2=3．881〉3．384，P〈0．05）。结论在非接触式全视野镜下对严重增生性糖尿病视网膜病变进行玻璃体手术可有效控制糖尿病视网膜病变的发展。手术预后与眼底病变程度成正相关。因此，对于糖尿病视网膜病变应强调早发现、早治疗。

Objective To evaluate the clinical efficacy of vitrectomy with noncontact panoramic viewing systems for severe proliferative diabetic retinopathy （PDR）.Methods Fifty-seven eyes in 44 cases with severe PDR underwent vitrectomy using the noncontact panoramic viewing systems.Results The follow-up ranged from 12 to 90 months.Retina was attached in 51 eyes （90%）.Vision was improved in 18 of 23 eyes with stage V PDR, but only in 18 of 34 eyes with stage Ⅵ PDR, the difference was significant （P〈 0.05 ）.Conclusions The vitrectomy using the noncontact panoramic viewing systems is safe and effective for late PDR.The vision after surgery is positively correlated to the patient＇ s condition prior to operation.Therefore early diagnosis and treatment are strongly recommended.