糖尿病视网膜病变玻切术后视力不佳的原因分析

Analysis on cause of poor postoperative visual acuity after vitrectomy for severe proliferative diabetic retinopathy

目的分析增生性糖尿病视网膜病变行玻璃体切除术后病情平稳但视力恢复不佳的原因。方法回顾性分析22例（29眼）玻璃体切除术后病情平稳的增生性糖尿病视网膜病变，根据视力恢复情况病例分为视力改善组和无改善组。术后随访6—12个月，分析影响视力恢复及发生并发症的相关因素。结果视力无改善组糖化血红蛋白水平（8．21±1．57）％明显高于视力改善组（7．11±1．18）％，logistic回归分析发现术后视力与糖化血红蛋白水平密切相关，术后黄斑水肿与肌酐水平有关。结论血糖水平与增生性糖尿病视网膜病变玻璃体切除术后视力恢复不佳有关。

Objective To analyse the cause of poor postoperative vision acuity after vitrectomy for the treatment of proliferative diabetic retinopathy. Methods The data of 29 eyes of 22 patients with proliferative diabetic retinopathy were enrolled and analyzed retrospectively, they were in stable condition after vitrectomy. All eases were divided into visual acuity improved group （group 1 ） and no improved group （group 2）according to visual acuity postoperative. The follow-up time was 6-12 months. The related factors of poor visual acuity and surgical complications were analyzed. Results The glycated hemoglobin level in group 2 of （ 8.21 ± 1.57 ） % was significantly higher than that of （7.11 ± 1.18 ） % in group 1. The glycated hemoglobin level was significantly associated with poor visual acuity and the ereatinine level was significantly associated with diabetic macular edema by logistic regression analysis. Conclusion The poor glucose regulation may indicate worse visual acuity after successful vitrectomy for severe diabetic retinopathy.