康柏西普辅助玻璃体切除术治疗糖尿病视网膜病变的效果

The efficacy of Conbercept assisted vitrectomy for severe proliferative diabetic retinopathy

目的观察康柏西普（Conbercept）玻璃体内注射联合23G微创玻璃体切除术治疗严重增生型糖尿病视网膜病变（PDR）的效果。方法回顾性分析39例（43只眼）康柏西普玻璃体内注射联合23G微创玻璃体切除术治疗严重PDR的病历资料。比较术前、术后1周、1个月、3个月、6个月最佳矫正视力（BCVA）和黄斑中心区厚度（CMT）的变化，测定术前术后眼压，记录手术时间和手术情况。结果43眼术后随访6个月，BCVA和CMT术后1周、1个月均有明显变化（P〈0．05），但3个月与6个月无明显变化（P〉0．05）。手术平均时间（65．21±17．01）min，术后出现一过性高眼压者3眼，占6．97％，出现医源性视网膜裂孔者2眼，占4．62％，术后填充硅油或气体者2眼，占4．62％，视网膜复位者41眼，占95．35％，无术后出血者。结论康柏西普玻璃体内注射联合微创玻璃体切除术效果是肯定的，但术后长期CMT的降低以及BCVA的改善尚有待进一步探讨。

Objective To observe the clinical efficacy of 23G microinvasive vitrectomy assisted by intravitreal injection of Conbercept for severe proliferative diabetic retinopathy. Methods A retrospective analysis data of medical material of 43 eyes of 39 cases with severe proliferative diabetic retinopathy treated with 23G vitrectomy assisted by intravitreal injection of Conbercep was performed. The best corrected visual acuity （BCVA）and the central macular thickness（CMT） were compared pre-postoperative with 1 week, 1 month, 3 months and 6 months postoperatively. The pre-postoperative intraocular pressure was measured, and the operative time and other operative results were recorded. Results In 6 months follow-up, BCVA and CMT were different in 1 week, 1 month, the difference was statistically significant （ P 〈 0.05 ）, but the difference was not statistically significant in 3 months and 6 months （ P 〉 0.05 ）. The average operation time was （65.21 ± 17.01 ）min,Three eyes occurred higher postoperatively intraocular pressure, 2 eyes occurred iatrogenic retinal hole ,2 eyes were filled with silicone oil or gas, and retinal reattaehment was observed in 41 eyes, which accounted for 6. 97%, 4. 62%, 4. 62% and 95. 35%, respectively. There were no postoperative bleeding in the period of follow-up. Conclusion The vitrectomy assisted by intravitreal injection of Conbercept is effective. But the improvement of BCVA and CMT postoperative 6 months will be further explored.