糖尿病性盲患者玻璃体手术后的脱盲率及未脱盲原因分析

Causes of blindness after vitreoretinal surgery for proliferative diabetic retinopathy

目的分析因增殖性糖尿病视网膜病变(PDR)致盲行玻璃体手术后脱盲率及未脱盲的原因。方法对110例(142眼)符合盲标准并行玻璃体手术的糖尿病视网膜病变患者的临床资料进行分析,观察术后的脱盲率并分析未脱盲的原因。结果研究所纳入的142只盲眼中,术后脱盲91眼,脱盲率为64.1%。未脱盲的主要原因包括术前牵拉性视网膜脱离、视网膜血管严重闭塞、视神经病变、弥漫性黄斑水肿和新生血管性青光眼等。结论玻璃体手术可以使部分糖尿病性盲的患者脱盲,而未脱盲的原因较复杂,避免糖尿病性盲的关键在于早期预防和早期治疗。

Objective To analyze the risk factors of blindness after vitreoretinal surgery for proliferative diabetic reti- nopathy （PDR）. Methods A total of 142 eyes of 110 patients undergoing vitrectomy for PDR were followed up. Re- salts In the 142 eyes with diabetic blindness, 91 （64.1% ） were improved in visual acuity and postoperative blindness occured in 51 （35.9%） . The chief causes of blindness were traction retinal detachment, severe retinal vascular occlu- sion, optic neuropathy, diffuse macular edema and neovascular glaucoma. Conclusion The incidence of blindness af- ter vitreoretinal surgery for PDR is high, and early prevention and treatment is important to avoid diabetic blindness.