Ranibizumab辅助玻璃体手术治疗增殖性糖尿病视网膜病变的临床观察

Observation of Vitrectomy Assisted by Ranibizumab for Proliferative Diabetic Retinopathy

目的探讨增殖性糖尿病视网膜病变术前应用Ranibizumab的有效性。方法对20例20眼增殖性糖尿病视网膜病变行玻璃体手术治疗患者的资料进行回顾性分析。其中10例10眼术前行玻璃体腔内注射Ranibizumab,为A组;另10例10眼直接行玻璃体切除手术,为B组。术后观察3个月,比较两组患者术中及术后情况。结果 A组的平均手术时间为(71.4±9.6)min,B组为(102.8±11.4)min,两组差异有统计学意义(t=6.644,P<0.01)。A组术中需电凝止血者1例,B组6例。术中出现医源性视网膜裂孔者A组1例,B组4例。术后玻璃体腔再出血者A组0例,B组3例。术后视力A组改善优于B组。结论增殖性糖尿病视网膜病变行玻璃体手术前应用Ranibizumab,可有效减少术中出血,缩短手术时间,降低术后并发症。

Objective To investigate the effectiveness of intravitreal Ranibizumab injections preoperatively for proliferative diabetic retinopathy.MethodsA retrospective analysis was made on 20 eyes of 20 patients sufferring from Proliferative Diabetic Retinopathy and treated by vitrectomy. Ten eyes of 10 patients were assigned to group A who received an intravitreal injection of Ranibizumab, and others were assigned to group B who underwent vitrectomy without prepoperative intravitreal injection. Recording and comparing preoperative and postoperative conditions and the data during 3-months follow-up postoperatively.Results Mean surgical time was （71.4±9.6） minutes in group A versus （102.8±11.4） minutes in group B and the difference was statistically signiifcant （t=6.644,P〈0.01）. Endodiathermy cases were 1 in group A versus 6 in group B. The iatrogenic retina tear occurred in 1 of 10 eyes in group A versus 4 eyes in group B. Recurrent postoperative intravitreal hemorrhage occurred in 3 eyes in group B, but none in group A. Improvement of postoperative visual acuity of group A was better than group B as well.Conclusions Preoperative use of Ranibizumab for proliferative diabetic retinopathy is effective for reducing intraoperative intravitreal hemorrhage, thus facilitates surgery procedures and reduces postoperative complications.