康柏西普在糖尿病视网膜病变术前应用时机的研究

Clinical study on the timing of preoperative application of conbercept in proliferative diabetic retinopathy

目的观察康柏西普在增生性糖尿病性视网膜病变(PDR)术前应用的最佳时机。方法回顾性分析2017年5月至2018年7月PDR进行玻璃体切除术75例(75眼),随机分为A、B两组,A组38例(38眼),于术前7天玻璃体内注射康柏西普;B组37例(37眼),于术前3天玻璃体内注射康柏西普。观察比较两组手术耗时、术中术后并发症和术后6个月的视力。结果两组患者术后视力均较术前明显提高(t=8.854,P=0.000);术后复发玻璃体积血者,A组1眼(2.6%),B组7眼(18.9%),(P=0.028)。术后出现高眼压,A组有5眼(13.2%),B组有7眼(18.9%),两组比较差异无统计学意义(χ^2=0.463,P=0.496)。两组患者手术耗时、术中视网膜出血情况、医源性裂孔发生率、硅油或气体填充率,差异均无统计学意义(P=0.502、0.518、0.304、0.444、0.720)。结论康柏西普在PDR行玻璃体切除术前应用能显著提高患者视力,术前7天应用康柏西普者术后玻璃体积血的发生率较术前3天应用者少。

Objective To observe the best time of application of conbercept before vitrectomy for proliferative diabetic retinopathy (PDR). Methods The data of 75 eyes of 75 cases of proliferative diabetic retinopathy who underwent vitrectomy from May 2017 to Jul. 2018 were retrospectively analyzed. All cases were divided into two groups randomly. Group A , 38 eyes of 38 cases, received intravitreal injection of Conbercept at 7 days before operation, and group B, 37 eyes of 37 cases, received intravitreal injection of Conbercept 3 days before operation. The operation time, intraoperative and postoperative complications and the visual acuity at 6 months postoperatively were observed and compared between the two groups. Results Postoperative visual acuity of the two groups were significantly improved (t=8.854, P=0.000). Postoperative recurrence of vitreous hemorrhage occurred in 1 eye (2.6%) of group A and 7 eyes (18.9%) of group B (P=0.028). Postoperative intraocular hypertension occurred in 5 eyes (13.2%) of group A and 7 eyes (18.9 %) of group B, the difference was not statistically significant (χ^2 =0.463, P=0.496). The difference were not statistically significant between the two groups in operation time, intraoperative retinal hemorrhage, iatrogenic tear incidence, silicone oil or gas tamponade rate (P=0.502, 0.518, 0.304, 0.444, 0.720). Conclusion Application of Conbercept before vitrectomy can improve the visual acuity for patients with PDR. The incidence of vitreous hemorrhage in patients applicated of Conbercept at 7 days before vitrectomy can reduce the incidence of vitreous hemorrhage than that in patients applicated of Conbercept at 3 days.