玻璃体术后硅油界面前纤维膜对Ⅵ期糖尿病视网膜病变疗效影响

Effect of proliferative membrane in front of silicone oil after vitrectomy on Ⅵ period proliferative diabetic retinopathy

目的 观察玻璃体术后硅油界面前纤维膜对Ⅵ期糖尿病视网膜病变疗效的影响.方法 回顾性病例系列研究.对2011年3月至2013年3月因Ⅵ期PDR于安阳市眼科医院接受玻璃体切割＋晶状体切除＋剥膜＋全视网膜光凝＋硅油填充手术的42例（50只眼）患者,根据玻璃体术后硅油前界面的变化,将患者分为硅油界面前纤维膜组12例（12只眼）和无硅油界面前纤维膜的对照组30例（38只眼）,随访3个月,对两组患者术后的最佳矫正视力、眼压、睫状体脱离和周边部视网膜脱离情况进行统计学分析.结果 术后3个月,硅油界面前纤维膜组患者眼压为（10.34±3.06） mmHg,对照组患者眼压为（15.67±4.28） mmHg,两组眼压比较差异有统计学意义（t=3.99,P=0.00）;比较硅油界面前纤维膜组和对照组患者术后最佳矫正视力、睫状体脱离和周边部视网膜脱离情况,差异均有统计学意义（x2=14.18、7.24、5.23,P=0.048、0.01、0.02）.结论 玻璃体术后出现硅油界面前纤维膜使术眼发生低眼压、睫状体脱离和周边部视网膜脱离的情况明显增加,严重影响病人视功能的恢复.

Objective To observe the effect of proliferative membrane in front of silicone oil after vitrectomy on Ⅵ period proliferative diabetic retinopathy.Methods Retrospectively analyzed 42 patients （50 eyes） with Ⅵ period proliferative diabetic retinopathy treated with vitrectomy and intravitreal injection with silicone oil 2011 to 2013.Fifty eyes were divided into two groups by means to having proliferative membrane in front of silicone oil or no.The vision,intraocular pressure,ciliary detachment and retinal detachment of all the 50 eyes after surgery were observed.Results Intraocular pressure of two groups after vitrectomy were （10.34±3.06）mmHg and（15.67±4.28）mmHg respectively,the difference was significant,（t =3.99,P =0.00）.Chi-square test was used to analyze the vision,ciliary detachment and retinal detachment of two groups,the difference was significant （x2=14.18,7.24,5.23; P =0.048,0.01,0.02）.Conclusions With proliferative membrane in front of silicone oil after vitrectomy will cause more of lower intraocular pressure,ciliary detachment and retinal detachment than usual,and seriously affect the recovery of patient＇s visual function.