增殖性糖尿病视网膜病变的玻璃体切除术的疗效分析

Effect analysis of the vitrectomy for the treatment of proliferative diabetic retinopathy

目的对增殖性糖尿病性视网膜病变的玻璃体切除手术的疗效进行分析。方法对186例(212眼)行玻璃体切除术的增殖性糖尿病视网膜病变患者的临床资料进行回顾性分析。结果术后随访6～48个月,术后视力改善168眼(79.25%),其中Ⅳ～Ⅴ期132眼(78.57%),Ⅵ期36眼(21.43%);32眼(15.09%)视力不变,其中Ⅳ～Ⅴ期24眼(75.00%),Ⅵ期8眼(25.00%);12眼(5.66%)视力下降,其中Ⅳ～Ⅴ期4眼(33.33%),Ⅵ期8眼(66.67%)。视力恢复,Ⅳ～Ⅴ期组明显好于Ⅵ期组,差异有统计学意义(P<0.01)。结论增生性糖尿病视网膜病变的严重程度不同对术后的视力恢复有不同的影响。早期手术效果更佳。有效的、足量的全视网膜激光光凝是治疗增生性糖尿病视网膜病变的必要手段,可以有效降低糖尿病眼病的致盲率。

To analyze the operative effect of the vitrectomy in treating proliferative diabetic retinopa- thy （PDR）. [Methods] 186 cases （212 eyes ） of PDR treated with vitrectomy were studied retrospectively. [Results] The patients were followed up for 6-48 months after operation. Visual Acuity （VA） improved in 168 eyes （79.25%） including 132 eyes（78.57%） with IV-V stage PDR and 36 eyes （21.43%） with VI stage PDR. No Changes in VA was found in 32 eyes （15.09%） including 24 eyes （75.00%） with IV-V stage PDR and 8 eyes （25.00%） with VI stage PDR and VA decreased in 12 eyes （5.66%） including 4 eyes （33.33%） with Ⅳ-Ⅴ stage PDR and 8 eyes （66.67%） with VI stage PDR. VA of IV-V stage PDR improved obviously than VI stage PDR. Between two groups, the differ- ence was statistically significant （P 〈0.01）. [Conclusion] The different stage of the PDR can have the different af- fect on VA. Early vitrectomy is good. Effective and enough panretinal photocoagulation （PRP） are necessary and can reduce the ratio of the blindness of proliferative diabetic retinopathy.