糖尿病视网膜病变玻璃体切割术中应用曲安奈德的双重效果

Twin Effects of Using Triamcinolone Acetonide in the Vitrectomy Surgery of Diabetic Retinopathy

目的评价增殖性糖尿病视网膜病变（PDR）玻璃体切割手术（PPV）中应用曲安奈德（TA）对于术中清除残留玻璃体、术后抗炎的效果。方法回顾性分析本院2006年12月~2008年12月因增殖性糖尿病视网膜病变住院接受玻璃体切割术治疗患者27例29眼,术中常规PPV后辅以TA标记,观察其清除残留玻璃体皮质的作用,比较手术前后视力、眼压,观察术后眼内炎症反应及并发症。结果由于应用了TA,术中玻璃体后皮质清除较为干净,术后前房炎症反应较轻、并发症少,术后视力有明显改善。尽管术后眼压升高,但可经药物控制。结论玻璃体切割术治疗增殖性糖尿病视网膜病变辅以TA治疗,不仅有利于术中清除残留玻璃体,而且有利于提高术后视力、减少术后炎症反应及并发症的发生。

Objective To evaluate the removal residual vitreous and postoperative anti-inflammatory effect of applicating triamcinolone acetonide（TA） in surgery of pars plana vitrectomy（PPV） for proliferative diabetic retinopathy（PDR）. Methods 27 cases of 29 eyes of proliferative diabetic retinopathy treated by vitrectomy in our hospital from December 2006 to December 2008 were retrospectively analyzed.Marked with TA after conventional vitrectomy,the effect of removing the residual vitreous cortex was observed,and the visual acuity and intraocular pressure before and after surgery was compared,post-operation intraocular inflammatory and other complications was also observed. Results As the result of applicating TA,the removal of posterior vitreous cortex is much clean.Less postoperative anterior chamber inflammation,fewer complications and a significant improvement in visual acuity was achieved.Although there was the postoperative intraocular pressure,it can be controlled by drugs. Conclusion The proliferative diabetic retinopathy vitrectomy assisted by TA is not only conductive to the removal of residual vitreous surgery,but will also help to improve the postoperative visual acuity,reducing postoperative inflammatory response and complications.