玻璃体切割联合超声乳化人工晶状体植入术治疗增生性糖尿病视网膜病变合并白内障的疗效观察

Efficacy of vitrectomy combined with phacoemulsification and intraocular lens implantation in treatment of proliferative diabetic retinopathy and cataract

目的探讨玻璃体切割联合超声乳化人工晶状体植入术治疗增生性糖尿病视网膜病变合并白内障的疗效，为临床治疗提供进一步的参考依据。方法回顾性分析我院自2011年1月～2013年1月收治的增生性糖尿病视网膜病变合托白内障34例的临床资料，其中男19例（22眼），女15例（18眼），右眼18眼，左眼19眼，双眼3眼。年龄38～73岁，平均年龄（56．1±4．2）岁，比较术前及术后视力改善情况及并发症情况。结果所有患者术后视力均有不同程度改善，术前视力〈0．1者34眼，0．1～0．5者6眼，术后6个月视力〈0．1者下降为3眼，0．6～1．0者上升至32眼。术后视力与术前相比。差异有统计学意义（P〈0.05）。40只眼中5只眼有局限的视网膜牵拉，出现视网膜水肿，11眼术后出现后囊浑浊。13只眼出现一过性角膜水肿，前房明显的纤维素渗出，16只眼出现继发玻璃体出血。17眼出现一过性眼压升高，经短暂降眼压药物治疗后眼压得以控制。1只眼随访2个月时发生视网膜再脱离、再次手术后复位。结论玻璃体切割联合超声乳化人工晶状体植入术治疗增生性糖尿病视网膜病变合并白内障疗效确切，值得推广和应用。

Objective To investigate the effect of vitrectomy combined with phacoemulsification and intraocular lens implantation in the treatment of proliferative diabetic retinopathy and cataract treatment,for clinical treatment provide further reference. Methods A retrospective analysis in our hospital from January 2011 to January 2013 were treated proliferative diabetic retinopathy and cataract clinical data of 34 patients,included 19 males （22 eyes） and 15 females （18 eyes）, the right eye in 18 eyes, 19 eyes of left eye, eyes three cases. Aged 38-73 years, mean age （56.1±4.2） years of age, compaed preoperative and postoperative visual acuity improved conditions and complications. Results All patients were improved visual acuity, preoperative visual acuity 〈0.1 34 eyes, by 0.1-0.5 total 6 eyes,after 6 months visual acuity 〈0.1 were reduced to three eyes, by 0.6 to 1.0 up to 32 eyes,compared with preoperative visual acuity, the difference was statistically significant （P〈0.05）. 40 eyes of five eyes with localized retinal traction,retinal edema, l 1 postoperative posterior capsular opacification. Most eye surgery early postoperative anterior chamber may be mild inflar, nmatory response, 13 eyes had transient corneal edema, anterior chamber fibrin exudate evident by dilation and topical steroid therapy disappeared after 4-5 d, 16 eyes with secondary vitreous hemorrhage,included 7 cases with elevated blood sugar. 17 had transient intraocular pressure,after a short hypotensive drug therapy to control intraocular pressure.An eye followed for 2 months and then retinal detachment surgery again after a reset. Conclusion Vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy and cataract efficacy, should be promoted and applied.