玻璃体切割视网膜复位术与抗新生血管药物联合治疗严重增殖性糖尿病视网膜病变分析

Analysis of the Effect of Vitreous-body Cutting Combined with Retinal Reposition and Antiangiogenic Agents in the Treatment of Severe Proliferative Diabetic Retinopathy

目的探究抗新生血管药物与玻璃体切割视网膜复位术联合治疗严重增殖性糖尿病视网膜病变的应用效果。方法整群选取该院2014年10月—2015年8月收治的40例48眼的严重PDR患者的临床资料进行回顾性分析,全部患者均进行雷珠单抗（lucentis）联合玻璃体切除手术眼内填充硅油（或者是惰性气体）。结果全部手术患者在术中的出血情况较少;48例眼中,采用玻璃体腔填充20%的C3F8 14例,填充16%C3F8 25例,玻璃体腔填充硅油的有9例,在手术后的14~28 d后进行眼底彩色荧光造影,且逐渐将PRP有效完成。术后的眼压为13~35 mm Hg,选择降低眼压药物对局部进行点眼后,都能够将眼压控制在〈20 mm Hg内,最佳的矫正视力为0.07~0.4。结论抗新生血管药物与玻璃体切割视网膜复位术联合治疗严重增殖性糖尿病视网膜病变的效果显著,可以将术中出血情况明显减少,降低术后并发症发生率,促使患者术后最佳矫正视力明显提高。

Objective To study the application effect of vitreous-body cutting combined with retinal reposition and antian- giogenie agents in the treatment of severe proliferative diabetic retinopathy （PDR）. Methods An analysis was conducted on the clinical data of 40 cases （48 eyes） with severe PDR admitted in our hospital from October 2014 to August 2015. All the patients were given lucentis and vitrectomy combined with silicone oil or inert gas filled in the vitreous cavity of the surgi- cal eye. Results The incidence of intraoperative blood loss was low in all the patients. In 48 eyes, the vitreous cavity of 24 eyes was filled with 20% of C3F8, and that of 25 eyes was filled with 16% of C3F8, that of 9 eyes was filled with silicone oil. Fundus color photography and fundus fluorescence angiography were performed 14~28d after surgery, and the PRP was effectively completed after the operation. Postoperative intraocular pressure （IOP） was 13-35mmHg, but that was controlled in less than 20 mrnHg after local eye droppings with the drugs of decreasing intraocular pressure. And the best corrected vi- sual acuity was 0.07-0.4. Conclusion Vitreous-body cutting combined with retinal reposition and antiangiogenic agents in the treatment of severe PDR have significant effect, which can reduce the intraoperative blood loss and the incidence of postoperative complications and improve the postoperative best corrected visual acuity.