增生性糖尿病视网膜病变合并白内障不同手术方法比较

Comparative analysis of different surgery methods in treatment of proliferative diabetic retinopathy patients with cataract

目的比较两种手术方式治疗增生性糖尿病视网膜病变（PDR）合并白内障的疗效。方法79例PDR合并白内障患者，按手术方法不同分为超声乳化＋玻璃体切除组（A组）41例（52眼）和晶体切除＋玻璃体切除组（B组）38例（48眼）。观察常规眼压、虹膜新生血管（INV）、眼底荧光造影的变化。结果A组术后视力提高为42眼（80．0％），明显高于B组的30眼（62．5％）（x2=4．26，P〈0．05）；A组术后虹膜新生血管发生率3．8％，明显低于B组的12．5％（X2=4．02，P〈0．05）；两组黄斑水肿发生及术后眼底荧光造影检查结果差异无统计学意义（x2=2．02，2．58，均P〉0．05）。结论白内障超声乳化联合玻璃体切除术治疗PDR合并白内障的效果优于后路晶体切除联合玻璃体切除术。

Objective To compare the effects of two treatment methods in the treatment of proliferative diabetic retinopathy （PDR） patients with cataract. Methods 79 PDR patients with cataract, according to the different surgical methods were divided into：phacoemulsification with lensectomy of 41 cases （52 eyes） in Group A and crystal resection with lensectomy of 38 cases （ 48 eyes ） in Group B. The changes of eye pressure, iris neovascularization （INV） ,fundus fluorescein angiography were observed. Results The visual acuity increased in 42cases （80.0%） postoperative in group A, which was significantly higher than that of group B [ 30 cases （ 62.5 % ） ] （ X2 = 4.26, P 〈 0. 05 ） ;The incidence of INN was 3.8 % in Group A ,which was significantly lower than that of Group B（ 12.5% ） （ X2 = 4.02, P 〈 0.05 ） ;The macular edema and postoperative fundus fluorescein angiography showed no significant difference in two groups （ X2 = 2.02, 2.58, all P 〉 0.05 ）. Conclusion The effect of phacoemulsification with vitrectomy for the treatment of PDR with cataract was superior to the posterior lens removal of vitrectomy surgery.