玻璃体切除术联合雷珠单抗治疗黄斑水肿观察

Observation of vitrectomy combined with Ranibizumab for macular edema

目的评价25G玻璃体切除联合术前玻璃体内注射雷珠单抗治疗黄斑水肿的效果。方法回顾性分析2013年1月至2017年9月郑州市第二人民医院120例(120眼)黄斑水肿的资料,患者随机分为两组。对照组60例,采用25G玻璃体切除手术,观察组60例,25G玻璃体切除术前联合玻璃体内注射雷珠单抗。术后观察6个月。结果术前视力两组间差异无统计学意义(t=0.073,P=0.943);术后1周、2周、1个月及3个月视力,两组相比差异有统计学意义(F=55.420,P=0.000);治疗前黄斑部视网膜厚度两组间差异无统计学意义(t=1.297,P=0.211);术后1周、2周、1个月及3个月黄斑部视网膜厚度两组间差异有统计学意义(F=153.634,P=0.000);手术时间:观察组(44.20±6.44)min,对照组(62.44±8.87)min,两组间差异有统计学意义(t=4.900,P=0.000);两组术中出血情况比较,两组间差异有统计学意义(x2=4.236,P=0.040)。结论25G玻璃体切除术联合术前玻璃体内注射雷珠单抗治疗黄斑水肿,能够迅速改善患者视力,快速消退水肿,缩短术中操作时间及减少并发症。

Objective To evaluate the effect of 25G vitrectomy combined with intravitreal injection of Ranibizumab for the treatment of macular edema. Methods The data of 120 eyes of 120 patients from Jan. 2013 to Sep. 2017 were analyzed retrospectively. The patients were divided randomly into 2 groups. The control group, 60 patients, underwent 25G vitrectomy, and the observation group, 60 cases, received 25G vitrectomy after Ranibizumab intravitreal injection. The efficacy of two groups were observed. Results The difference of visual acuity before operation was not statistically significant (t=0. 073, P=0. 943), at 1, 2 weeks, 1 and 3 months after operation, the difference of visual acuity were statistically significant ( F =55. 420, P=0. 000) between the two groups. The difference of retinal thickness of macular before operation was not statistically significant (t=1. 297, P=0. 211). At 1, 2 weeks, 1 and 3 months after operation, the difference were statistically significant between the two groups (F=153. 634, P=0. 000). Operation time were (44. 20 ± 6. 44) min in the observation group, and (62. 44 ± 8. 87) min in the control group. The difference was statistically significant between the two groups (t=4. 900, P=0. 000). The difference of intraoperative bleeding was statistically significant between the two groups (χ2 =4. 236, P =0. 040). Conclusion The treatment of 25G vitrectomy combined with Ranibizumab intravitreal injection before operation for macular edema, can improve visual acuity fastly, regresse of macular edema rapidly and reduce of intraoperative operating time and complications.