玻璃体切除术联合视网膜激光光凝治疗严重增殖性糖尿病视网膜病变的疗效分析

Vitrectomy combined with photocoagulation of retina laser in treatment of severe proliferative diabetic retinopathy

目的 :分析玻璃体切除术治疗严重增殖型糖尿病视网膜病变 (PDR)的疗效。 方法 :PDR患者 31例 (35眼 ) ,在控制血糖、血压情况下行玻璃体切除术 ,术中均作次全或全视网膜光凝。分析手术前后及随访 6～ 32个月的资料。结果 :最后随访时 ,视网膜平伏 ,眼底清晰可见 ,保留一定视力的手术成功眼为 2 9眼 ,最后成功率为 82 .9% ;病变较轻组比病变重度组成功率高 (P<0 .0 5 ) ;出血时间 >6个月组较出血时间≤ 6个月组成功率低 (P<0 .0 5 )。手术成功眼最后视力有明显提高 ,6 2 .9%达0 .1以上 ,2 8.6 %达 0 .4以上。 结论 :适时进行玻璃体切除术联合视网膜光凝治疗严重

Objective: To analyze the efficacy of vitrectomy treatment for severe proliferative diabetic retinopathy. Methods: To review and summarize the conditions of pre and post operation, as well as follow up in 31 cases. Results: At the end of the follow up study, the retina was flat, the least vision was retained, and the ocular fundus was clear in 29 eyes. The final success rate was 82.9%, higher in the group of less severe retinopathy than in the group of severe retinopathy ( P < 0.05), and lower in the group of vitreous hemorrhage > 6 months than in the group of vitreous hemorrhage ≤6 months ( P < 0.05). The final vision was significantly increased, better than 0.1 in 62.9%, better than 0.4 in 28.6%. Conclusion: Timely vitrectomy offers good therapeutic outcomes in the treatment of severe proliferative diabetic retinopathy. [