玻璃体切割联合保留前囊膜的晶状体切除治疗糖尿病性视网膜病变

Vitrectomy and lensectomy preserving anterior lens capsule for proliferative diabetic retinopathy

目的 对老年糖尿病性视网膜病变患者采取玻璃体切割联合保留前囊膜的晶状体切除治疗并进行随访观察，以探讨其临床疗效。方法 以我院２０１０年３月至２０１２年８月收治的增生型糖尿病性视网膜病变老年患者５７例（６０眼）为观察对象。所有患眼均采取玻璃体切割联合保留前囊膜的晶状体切除治疗，一期不进行人工晶状体植入而行硅油填充。观察患者术前术后视力变化及并发症发生情况。结果 术后随访１２～２３（１６．４±２．５）个月，患眼术后视力较术前提高者５５眼（９１．７％），视网膜复位率为１００％。术后有１１眼眼压增高，２眼出现虹膜新生血管，４眼发生局部虹膜粘连及４眼前囊膜３级混浊。结论 玻璃体切割联合保留前囊膜的晶状体切除是处理老年增生型糖尿病性视网膜病变的较好方法。

Objective To explore the curative effects of vitrectomy and lensectomy preserving anterior lens capsule for old patients with proliferative diabetic retinopathy. Methods Data of 57 patients （50 eyes） with proliferative diabetic retinopathy who were treated by vitrectomy and lensectomy preserving anterior lens capsule in our hospital from March 2010 to August 2012 were reviewed,and the change of vision after operation and the complications were observed. Results All patients were followed- up for 12 -23 months ,the average time was （15.4 ± 2.5 ）months. The vision after operation increased in 55 eyes（91. 7% ） ,and the rate of retinal reattachment was 100%. There were 11 eyes with a transient increase of intraocular pressure ,2 eyes with iris neovascularization,4 eyes with synechia of iris,and 4 eyes with 3 grade turbidity of anterior lens capsule. Conelusion Vitrectomy and lensectomy preserving anterior lens capsule is a good operation method for old patients with proliferative diabetic retinopathy.