玻璃体切除治疗增生性糖尿病视网膜病变

Vitrectomy for proliferative diabetic retinopathy

目的:观察玻璃体视网膜手术治疗增生性糖尿病视网膜病变的临床效果。方法:回顾性分析55例65眼经过玻璃体切除、剥膜、眼内光凝、硅油或C3F8填充术的晚期增生性糖尿病视网膜病变的临床资料,术后随访6mo^1a,观察视力、眼压、视网膜情况以及手术并发症。结果:患者65眼均顺利完成玻璃体手术,32眼眼内填充硅油,8眼填充C3F8,25眼平衡盐液填充。术后视力手动者2眼,数指~0.05者18眼,>0.05~0.1者28眼,>0.1~0.3者12眼,>0.3者5眼,42眼视力提高。7眼视网膜裂孔,8眼有局限性纤维增生膜残留,5眼视网膜脱离,18眼眼压升高,12眼再发玻璃体出血,36眼术后补充光凝治疗1~3次。结论:玻璃体切除术联合眼内激光治疗增生性糖尿病视网膜病变患者是一种有效的治疗手段,硅油填充对于眼内出血有限制作用。

AIM： To observe the clinical effect of vitrectomy for proliferative diabetic retinopathy （PDR）. METHODS： The clinical data of 55 cases （65 eyes）, underwent vitrectomy, membrane peeling, endolaser photocoagulation and silicone oil or C3F8 injection, were retrospectively studied. During 6 months to 1 year follow up period, visual acuity, intraocular pressure, retinal conditions and complications were observed. RESULTS： All 65 eyes received vitrectomy, of which silicone oil was tamponaded in 32 eyes, C3F8 was injected in 8 eyes, BBS was filled in 25 eyes. Visual improvement achieved in 42 eyes. Two eyes were manually vision, form count fingers to 0. 05 in 18 eyes, 〉0.05-0.1 in 28 eyes, 〉0.1-0.3 in 12 eyes and 〉0. 3 in 5 eyes. Retinal hole was occurred in 7 eyes, limitations fibrosis membrane remained in 8 eyes, retinal detachment appeared in 5 eyes, lOP increased in 18 eyes, vitreous hemorrhage relapsed in 12 eyes, 36 eyes received supplemental photocoagulation treatment 1- 3 times after operation. CONCLUSION：Vitrectomy combined endophotocoagulation is an effective treatment for PDR, Silicone oil tamponade can limit the hemorrhage.