雷珠单抗辅助玻璃体切割术治疗增生性糖尿病视网膜病变

Pars plana vitrectomy assisted by Ranibizumab for proliferative diabetic retinopathy

目的观察雷珠单抗（Ranibizumab）辅助玻璃体切割术治疗增生性糖尿病视网膜病变的临床疗效及安全性。方法于2012年11月至2014年3月在广州医科大学附属第二医院眼科，回顾性分析22例（27只眼）增生性糖尿病视网膜病变（Ⅳ—Ⅴ期）患者，于玻璃体切割手术前6～7d行玻璃体腔注射0．05ml Ranibizumab，术后观察患者最佳矫正视力（BCVA）、眼压及眼部情况等。结果玻璃体腔注射Ranibizumab后，视网膜新生血管部分消退，玻璃体切割术中出血几率明显减少。其中19只眼患者视力提高（70．4％），5只眼视力不变（18．5％），3只眼视力下降（11．1％）。随访过程中未见与药物有关的眼部和全身不良反应。结论手术前玻璃体腔注射Ranibizumab有助于减少增生性糖尿病视网膜病变患者玻璃体切割术中出血及术后玻璃体再出血，可快速、稳定地提高患者的视功能，其安全性高、耐受性好，并能及时有效预防并发症。

Objective To observe the effect and safety of intravitreal Ranibizumab injection be- fore pars plana vitrectomy （PPV） in proliferative diabetic retinopathy （PDR） patients. Methods Twenty-two （27 eyes） patients with PDR （stage IV-V） were studied. Best corrected visual acuity （BCVA）, intraocular pressure and others were observed in patients injected with 0.05ml Ranibizumab 6-7 days before pars PPV. Results Retinal neovascularization partly vanished, haemorrhage during the vitrectomy decreased significantly. Visual acuity improved in 19 eyes （70.4%）, remained un- changed in 5 eyes （18.5%）, and decreased in three eyes （11.1%）. Few ocular and systemic adverse reactions were found during the follow-up. Conclusions Intravitreal Ranibizumab injection in PDR patients before PPV is useful for less hemorrhage during surgery and less vitreous hemorrhage post-operation. Visual function is improved fast and stead. It is safe and tolerable that can effective- ly prevent complications.