增殖性糖尿病视网膜病变玻璃体切除术后虹膜新生血管发生的影响因素

Influencing factors of iris neovascularization after vitrectomy for proliferative diabetic retinopathy

目的探讨增殖性糖尿病视网膜病变(DR)玻璃体切除术后虹膜新生血管发生的相关影响因素。方法回顾性分析2017年4月至2018年9月在本院接受增殖性DR玻璃体切除术治疗的348例患者的临床资料,分析术后发生虹膜新生血管的影响因素。结果348例增殖性DR患者于玻璃体切除术后,有25例患者存在虹膜新生血管现象,发生率为7.18%;两组性别、年龄、联合术式、联合填充物性质占比比较,差异均无统计学意义(均P>0.05);虹膜新生血管组术后视网膜脱离、未完成全视网膜光凝等占比均高于无虹膜新生血管组,差异均有统计学意义(均P<0.05);经logistic回归分析发现,术后视网膜脱落、未完成全视网膜光凝为玻璃体切除术后虹膜新生血管发生的影响因素(均OR>1,均P<0.05)。结论术后视网膜脱落、未完成全视网膜光凝为玻璃体切除术后虹膜新生血管发生的影响因素,故临床应积极采取对应干预措施,以控制术后虹膜新生血管的发生率,改善预后。

Objective To investigate the related factors of iris neovascularization after vitrectomy for proliferative diabetic retinopathy(DR).Methods The clinical data of 348 patients who underwent vitrectomy for proliferative DR in our hospital from April,2017 to September,2018 were retrospectively analyzed.The influencing factors of iris neovascularization were analyzed.Results Among the 348 patients,25 patients had iris neovascularization after vitrectomy,and the incidence was 7.18%.There were no statistical differences in the proportions gender,age,combined procedure,and combined filler properties between the two groups(all P>0.05).The proportions of retinal detachment and unfinished retinal photocoagulation in the iris neovascular group were higher than those in the non-iris neovascular group(both P<0.05).Logistic regression analysis found that postoperative retinal detachment and incomplete retinal photocoagulation were the influencing factors of iris neovascularization after vitrectomy(both OR>1 and both P<0.05).Conclusion Postoperative retinal detachment and incomplete retinal photocoagulation are the influencing factors of iris neovascularization after vitrectomy.Therefore,clinical intervention measures should be taken to control the incidence of postoperative iris neovascularization and to improve prognosis.