玻璃体切割联合曲安奈德注射治疗增生型糖尿病视网膜病变

Effect of vitrectomy with triamcinolone acetonide intravitreal injection in the treatment of proliferative diabetic retinopathy

目的观察玻璃体切割联合曲安奈德玻璃体腔内注射治疗增生型糖尿病视网膜病变的临床疗效及并发症。方法收集2011年2月至2012年1月增生型糖尿病视网膜病变患者60例69眼,患者均接受玻璃体切割手术,术中注射曲安奈德。观察术后视力及眼压情况,光学相干视网膜断层成像检测黄斑中心凹厚度变化及术后并发症。结果术后患者视力均有提高,术后3月稳定。最佳矫正视力为0.56±0.18.术后黄斑水肿减退,黄斑中心凹厚度减低,3月后基本恢复正常253±169μm。眼压术后有增加,术后7d为19.42±6.97mmHg,术后1月为24.14±11.25mmHg,用药后基本可以降至正常,术后3月19.21±6.45mmHg。结论玻璃体切割联合曲安奈德玻璃体腔内注射能减轻黄斑水肿,逐步改善视功能,是治疗增生型糖尿病视网膜病变的有效,安全手段。

[ Objective ] To study the effect of vitrectomy with triamcinolone acetonide injection for proliferative diabetic retinopathy. [ Methods ] The vitrectomy with triamcinolone acetonide were performed on 69 eyes of 60 patients.The outcome measures were included pre- an±d post operation optical coherence tomography（OCT） ,visual acurity and intraocular pressure. The complications were also observed. [ Resluts ] The visual acurity was increased to 0.56 ± 0.18 post operation which was stable after 3 month. The mecular edema were significantly reduced with the thickness decrease which was 253 ± 169 μm. The intraocular pressure increased which was 19.42 ± 6.97mmHg for 7days and 24.14 ± 11.25mmHg for lmonth after operation and it was improved for 3 months post operation for 19.21 ± 6.45mmHg. [ Conclusion ] Vitrectomy with triameinolone acetonide intravitreal injection is an effective procedure for reducing macular edema and it can improved the visual aeurity gradually. It is a effective and safe procedure for proliferative diabetic retinopathy.