玻璃体切除联合康柏西普治疗糖尿病视网膜病变

The efficacy of vitrectomy combined with conbercept in the treatment of diabetic retinopathy

目的评价玻璃体切除术联合康柏西普治疗增生型糖尿病视网膜病变(PDR)的临床效果。方法前瞻性病例对照研究。2016年10月至2017年12月收治的PDR62例(86眼),随机分为两组:单纯玻璃体切除术31例(41眼)为对照组,玻璃体切除术联合康柏西普玻璃体内注射31例(45眼)为联合组。术前、术后3个月和6个月检测最佳矫正视力(BCVA)、黄斑视网膜厚度以及黄斑中心区厚度(CMT),并记录并发症情况。结果联合组总有效率优于对照组(95.56%vs75.61%),差异有统计学意义(χ^2=5.5444,P=0.0185)。联合组术前、术后3个月和6个月BCVA(LogMAR)分别为1.13±0.19、0.71±0.22、0.38±0.16;而对照组分别为1.12±0.18、0.73±0.20、0.53±0.18。联合组术后6个月BCVA优于对照组,差异有统计学意义(t=4.0910,P=0.0001)。两组手术前后CMT、黄斑视网膜厚度及术后并发症发生率差异均无统计学意义(P>0.05)。结论采用玻璃体切除术联合康柏西普治疗PDR具有良好的临床效果。

Objective To evaluate the clinical efficacy of vitrectomy combined with intravitreal injection of conbercept in the treatment of proliferative diabetic retinopathy (PDR). Methods A prospective control study. The data of 86 eyes of 62 patients with PDR from Oct. 2016 to Dec. 2017 were analyzed. All cases were divided into two groups. The control group, 41 eyes of 31 cases, underwent vitrectomy only. The combined group, 45 eyes of 31 cases, underwent vitrectomy combined with intravitreal injection of conbercept. BCVA, macular area retinal thickness and central macular thickness(CMT) were measured before and 3, 6 months after surgery. The complications were recorded. Results The total effective rate of the combined group was better than that of the control group(95.56% vs 75.61%), the difference was statistically significant (χ^2=5.5444, P=0.0185). BCVA (LogMAR) of the combined group were 1.13±0.19, 0.71±0.22 and 0.38±0.16 before and 3, 6 months after surgery. BCVA of control group was 1.12±0.18, 0.73±0.20 and 0.53±0.18, respectively. BCVA at 6 months after surgery in the combined group was better than that in the control group (t=4.091, P=0.0001). The differences in CMT, macular retinal thickness and postoperative complications were not significant between the two groups (P>0.05). Conclusion Vitrectomy combined with intravitreal injection of conbercept for the treatment of PDR is effective.