不同方法治疗增生性糖尿病视网膜病变合并白内障的疗效比较

Clinical study on the treatment of PDR with cataract by vitreous cavity injection and intraocular lens implantation

目的:比较不同方法治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)合并白内障患者的疗效。方法:选取2014-01/2016-01本院收治PDR合并白内障患者261例266眼,随机分为对照组和研究组,对照组130例133眼,研究组131例133眼。对照组患者行玻璃体切割联合光激光凝治疗及超声乳化人工晶状体植入术,研究组先玻璃体腔注射贝伐单抗再行玻璃体切割联合激光光凝治疗及超声乳化人工晶状体植入术,术后对两组患者临床疗效进行对比分析。结果:对照组患者术后并发症均比研究组高,差异有统计学意义(P<0.05)。研究组67眼进行了补光凝,无1眼发生虹膜新生血管;对照组76眼进行了补光凝,有17眼发生虹膜新生血管,发生率为22.4%,差异有统计学意义(P<0.05)。两组患者术后视力比较差异有统计学意义(P<0.05);对照组患者术后黄斑水肿发生率比研究组高,差异有统计学意义(P<0.05)。结论:玻璃体腔内注贝伐单抗后再行玻璃体切割联合超声乳化人工晶状体植入术治疗PDR合并白内障临床效果良好。

AIM：To evaluate the clinical effect of phacoemulsification and intraocular lens（IOL）implantation in the treatment of proliferative diabetic retinopathy（PDR） with cataract..METHODS：Totally 261 patients（266 eyes） with PDR complicated with cataract in our hospital were selected and randomly divided into control group（133 eyes in 130patients） and study group（133 eyes in 131 patients）.The control group underwent vitrectomy combined with laser photocoagulation,phacoemulsification and intraocular lens implantation.The study group received intravitreal injection of bevacizumab before vitrectomy,laser photocoagulation,phacoemulsification and intraocular lens implantation.Clinical curative effect of two groups was analyzed.· RESULTS：The postoperative complications of the control group were higher than that of the study group,and the difference was statistically significant（P〈0.05）.In study group,67 eyes received photocoagulation again,iris neovascularization occurred in none eyes.In control group,76 eyes received photocoagulation again,iris neovascularization occurred in 17 eyes（22.4%）.The difference between the two groups was significant（P〈0.05）.The visual acuity of the study group was better than that of the control group（P〈0.05）.The incidence of macular edema in the control group was significantly higher than that in the study group（P〈0.05）.CONCLUSION：Intravitreal injection of bevacizumab with vitrectomy,phacoem ulsif ication and IOL implantation for cataract has good clinical effect for PDR.