严重PDR玻璃体切割术后雷珠单抗注射的效果观察（英文）

The effect of intravitreal ranibizumab after pars plana vitrectomy in severe proliferative diabetic retinopathy

目的:对严重增殖性糖尿病视网膜病变的患者行玻璃体切割术后行雷珠单抗注射的效果观察。方法:回归性分析。12例严重增殖性糖尿病视网膜病变患者(12眼)接受睫状体平坦部玻璃体切割术,同时给予硅油、惰性气体或者平衡液的玻璃体腔填充。在手术结束的同时给予雷珠单抗的玻璃体腔注射。结果:随访时间平均为2.75mo。这12眼中分别包括玻璃体积血(1眼);玻璃体积血伴纤维血管化增生(1眼);玻璃体积血伴牵拉性视网膜脱离(3眼);纤维血管化增生伴牵拉性视网膜脱离(2眼);玻璃体积血伴新生血管性青光眼伴牵拉性视网膜脱离(1眼);玻璃体积血伴纤维血管化增生伴牵拉性视网膜脱离(2眼);玻璃体积血伴纤维血管化增生伴新生血管性青光眼伴牵拉性视网膜脱离(1眼);玻璃体积血伴牵拉性孔源性视网膜脱离(1眼)。12眼中,8眼行玻璃体腔硅油填充,2眼行惰性气体填充,2眼行平衡液填充。所有的患者之前均未接受任何治疗。视网膜脱离复位率为10/10(100%)。1眼术后出现前房积血。9眼术后最佳矫正视力较术前提高,2眼无明显变化,1眼较术前下降。OCT检查显示8眼术后未见黄斑水肿。结论:玻璃体切割术后雷珠单抗注射对严重增殖性糖尿病视网膜病变患者有明显的治疗效果:手术成功率明显提高;患者视力显著提高;糖尿病黄斑水肿的发生概率减少;术中及术后并发症的发生率降低。

AIM：To observe the results of intravitreal injection ranibizumab after pars plana vitrectomy in severe proliferative diabetic retinopathy. METHODS： In this retrospective non- comparative interventional case series,twelve patients had undergone pars plana vitrectomy with silicone oil tamponade,perfluoropropane tamponade or balanced salt solution tamponade. At the end of the surgery,ranibizumab was injected into vitreous cavity. RESULTS： Average follows up was 2. 75 mo. Twelve eyes include vitreous haemorrhage（ 1 /12）, vitreous haemorrhage with fibrovascular proliferation（ 1 /12）,tractional retinal detachment with vitreous haemorrhage（ 3/12）,tractional retinal detachment with fibrovascular proliferation（ 2 /12）, tractional retinal detachment with vitreous haemorrhage and neovascular glaucoma（ 1 /12）,tractional retinal detachment with vitreous haemorrhage and fibrovascular proliferation（ 2 /12）,tractional retinal detachment with vitreous haemorrhage and fibrovascular proliferation and neovascular glaucoma（ 1 /12）,traction-rhegmatogenous retinal detachment with vitreous haemorrhage（ 1 /12）. Among these 12 eyes,8 /12 had silicone oil tamponade, 2 /12 had perfluoropropane tamponade, and 2 /12 had balanced salt solution tamponade. All the patients did not have any therapy before. The retinal attachment rate was 10 /10. One patient（ 1 /12） had hyphema after surgery. Postoperative best-corrected visual acuity improved in 9 eyes（ 9 /12）,was unchanged in one（ 2 /12）,decreased in（ 1 /12） eyes.Eight eyes（ 8 /12） did not have diabetic macular edema after surgery fromthe optical coherence tomography examination.CONCLUSION： Intravitreal ranibizumab after pars plana vitrectomy is useful in severe proliferative diabetic retinopathy. It can improve the success rate of surgery;improve postoperative best- corrected visual acuity;minimize the frequence of diabetic macular edema;minimize the frequence of operations and postoperative complications.