雷珠单抗联合曲安奈德在玻璃体切除术中应用的效果

The efficacy of application of ranibizumab combined with triamcinolone acetonide during vitrectomy for proliferative diabetic retinopathy

目的:观察玻璃体切除术前雷珠单抗玻璃体内注射,联合术中曲安奈德玻璃体腔注射治疗增生性糖尿病性视网膜病变(PDR)的效果。方法:回顾性分析2017年7月至2019年7月PDR 80例(80眼)的临床资料,患者分为两组,各40例(40眼)。两组手术前均行雷珠单抗玻璃体内注射,治疗组在手术结束时再行曲安奈德玻璃体腔注射。术后随访6个月,观察视力、黄斑中心区厚度(CMT)、眼压和玻璃体积血发生率。结果:治疗组术后7天、1个月和2个月视力均优于对照组(t=2.612,2.421,2.605;P=0.011,0.018,0.011)。治疗组CMT降低较对照组差异有统计学意义(P<0.05)。术后高眼压和玻璃体积血发生率两组间差异无统计学意义(P>0.05)。结论:玻璃体切除术前雷珠单抗及术中曲安奈德玻璃体注射治疗PDR效果良好。

Objective To observe the efficacy of application of intravitreal injection of ranibizumab before vitrectomy,combined with intravitreal injection of triamcinolone acetonide during vitrectomy for proliferative diabetic retinopathy(PDR).Methods The clinical data of 80 eyes of 80 patients with PDR from Jul.2017 to Jul.2019 were analyzed retrospectively.They were divided into two groups,40 eyes of 40 cases in each group.Both groups received intravitreal injection of ranibizumab before vitrectorny.The treatment group received intravitreal injection of triamcinolone acetonide at the end of operation.The visual acuity,central macular thickness(CMT),intraocular pressure and incidence of vitreous hemorrhage were observed at 6 months follow-up.Results The visual acuity of the treatment group at 7 days,1 and 2 months after operation was better than that of the control group,the difference were statistically significant(t=2.612,2.421,2.605;P=0.011,0.018,0.011).The difference of CMT were statistically significant between the two groups(P<0.05).There was no significant difference in the incidence of intraocular hyper-tension and vitreous hemorrhage between the two groups(P>0.05).Conclusion Intravitreal injection of ranibizumab before vitrectomy and intraoperative intravitreal injection of triamcinolone acetonide for the treatment of PDR is effective.