玻璃体腔注射雷珠单抗联合玻璃体切除术治疗PDR的疗效

Curative effect of intravitreal injection of ranibizumab combined with vitrectomy for PDR

目的:观察玻璃体腔注射雷珠单抗联合玻璃体切除术治疗增殖性糖尿病视网膜病变(PDR)的临床疗效。方法:回顾性研究。选取2016-05/2017-05于我院眼科治疗的PDR患者60例66眼,根据治疗方式不同分为两组,均为30例33眼。A组患者玻璃体切除术前3～5d注射雷珠单抗,B组患者仅行玻璃体切除术。比较两组患者术中医源性视网膜裂孔、玻璃体内出血及术后视力和并发症发生情况。结果:术中两组患者均出现医源性视网膜裂孔、玻璃体内出血,A组医源性视网膜裂孔眼数、术中玻璃体内出血发生率均低于B组(P<0.05)。术后A组患者视力改善优于B组(P<0.05)。手术治疗后,A组患者玻璃体内出血、高眼压和黄斑水肿眼数较B组少(P<0.05)。结论:术前接受玻璃体腔注射雷珠单抗联合玻璃体切除术治疗PDR能有效减少医源性视网膜裂孔、术中玻璃体内出血的情况发生,术后并发症较少,有利于患者恢复。

AIM: To observe the clinical effect of intravitreal injection of ranibizumab combined with vitrectomy in the treatment of proliferative diabetic retinopathy (PDR). METHODS: A retrospective study. Sixty patients (66 eyes) with PDR who underwent vitrectomy in our hospital from May 2016 to May 2017 were divided into two groups according to different treatment methods, 30 cases (33 eyes). ranibizumab were injected into vitreous cavity 3-5d before operation in group A, but not in group B. The incidence of iatrogenic retinal holes, intravitreal hemorrhage, visual acuity and complications were compared between the two groups. RESULTS:Iatrogenic retinal hiatus and intravitreal hemorrhage occurred in both groups during operation. The number of eyes with iatrogenic retinal hiatus and the incidence of intravitreal hemorrhage in group A were less than those in group B ( P <0.05). The visual acuity of group A was better than that of group B ( P <0.05). After operation, the number of eyes with intravitreal hemorrhage, high intraocular pressure and macular edema in group A was less than that in group B ( P <0.05). CONCLUSION: Preoperative intravitreal injection of ranibizumab combined with vitrectomy for PDR can effectively reduce iatrogenic retinal hiatus and intravitreal hemorrhage. Postoperative complications are less, which is conducive to the recovery of patients.