前期激光及曲安奈德应用对增殖性糖尿病视网膜病变玻璃体切割手术的影响

Effect of prior laser and triamcinolone acetonide on vitrectomy of proliferative diabetic retinopathy

目的探讨前期激光及曲安奈德(TA)应用对增殖性糖尿病视网膜病变(PDR)玻璃体切割手术的影响。方法选择PDR患者110例132眼,其中65例(72眼)曾接受规范化激光治疗,采用玻璃体切割联合术中玻璃体腔注入TA 4 mg/0.1 mL治疗;45例(60眼)未接受过激光治疗,术前1周玻璃体腔注入TA 4 mg/0.1 mL,再行玻璃体切割手术治疗。随访3个月,分析术后疗效。结果术后1个月裸眼视力、最佳矫正视力与术前比较均有统计学意义。术后多数患者前房炎症反应轻,眼压一过性升高41眼(31.1%),均药物治愈。结论早期规范化的激光光凝治疗及术前、术中应用TA,能减少术中出血及其他严重并发症。

Abstract ： Objective To observe the effect of prior laser and triamcinolone acetonide on vitrectomy of proliferative di- abetic retinopathy. Methods The study included 110 patients （132 eyes） with proliferative diabetic retinopathy who underwent vitrectomy. The 65 patients （72 eyes） who underwent prior and standard laser treatment accepted vitrectomy and triamcinolone acetonide （4 mg/0.1 mL） was injected into the vitreous. The 45 patients （60 eyes） who never un- derwent standard laser treatment accepted vitrectomy and triamcinolone acetonide （4 mg/0.1 mL） was injected into the vitreous one week before the vitrectomy. All the patients were followed up for 3 months, and the clinical curative effect was summarized. Results The natural visual acuity and best corrected vision acuity had significant differences l month after operation than before operation. The postoperative inflammatory reaction of anterior chamber was mild in the most patients. Postoperative intraocular press increased in 41eyes （31.1% ）, and turned normal after the patients used medi- cine. Conclusion The early standard laser treatment combined with triamcinolone acetonide before and during opera- tion is helpful to decrease the hemorrhage and other serious complications.