玻璃体切割术联合不同眼内填充物治疗增生型糖尿病视网膜病变的效果观察

Efficacy of vitrectomy combined with different intraocular filling materrials in the treatment of proliferative diabetic retinopathy

目的:探讨玻璃体切割术联合不同眼内填充物治疗增生型糖尿病视网膜病变(PDR)的效果。方法:回顾性分析2018年1月至2019年12月于开封市中心医院接受治疗的306例PDR患者(328眼)的临床资料,根据患者使用眼内填充物不同分为C3F8组(146例154眼)和硅油组(160例174眼)。比较两组患者术眼最佳矫正视力(BCVA),比较两组患者术眼术后玻璃体再积血发生率、发生时间差异,比较两组患者术中、术后并发症差异。结果:两组患者术后BCVA分级情况均优于术前,C3F8组患者术后总体BCVA分级情况优于硅油组(P均<0.05);硅油组患者术后玻璃体再积血发生率低于C3F8组(P<0.05),C3F8组患者玻璃体再积血发生时间早于硅油组(P<0.05);两组患者术中并发症、牵拉性视网膜脱离、虹膜红变、新生血管性青光眼发生率比较,差异未见统计学意义(P均>0.05),C3F8组患者白内障、一过性高眼压发生率低于硅油组(P均<0.05)。结论:C3F8、硅油联合玻璃体切割术治疗PDR均能促进PDR患者视力恢复,使用硅油作为眼内填充物的PDR患者术后玻璃体再积血发生率低于C3F8,使用C3F8的患者术后视力恢复效果更好。

Objective To explore the efficacy of vitrectomy combined with different intraocular filling materrials on proliferative diabetic retinopathy(PDR).Methods The clinical data of 306 PDR patients(328 eyes)who were treated in the Kaifeng Central Hospital from January 2018 to December 2019 were retrospectively analyzed.They were divided into C3F8 group(146 cases with 154 eyes)and silicone oil group(160 cases with 174 eyes)according to the intraocular filling materrials of patients.The treatment status of operated eyes such as best corrected visual acuity(BCVA)was compared between the two groups,and the incidence rate and occurrence time of postoperative vitreous re-hemorrhage of operated eyeswere compared between the two groups,and the occurrence of intraoperative complications and postoperative complications were compared between the two groups.Results The postoperative BCVA grading of the two groups was better than that before surgery,and the overall postoperative BCVA grading in C3F8 group was better than that in silicone oil group(P<0.05).The incidence rate of postoperative vitreous re-hemorrhage in silicone oil group was lower than that in C3F8 group(P<0.05),and the occurrence time of vitreous re-hemorrhage in C3F8 group was earlier than that in silicone oil group(P<0.05).There were no significant differences in the occurrence of intraoperative complications,traction retinal detachment,iris rubeosis and neovascular glaucoma between the two groups(P>0.05),and the incidence rates of cataract and transient high intraocular pressure in C3F8 group was lower than that in silicone oil group(all P<0.05).Conclusions C3F8 and silicone oil combined with vitrectomy for PDR both can promote thevisual acuity recovery of PDR patients.PDR patients using silicone oil as an intraocular filling materrialhave a lower incidence rate of postoperative vitreous re-hemorrhage than C3F8,and patients withC3F8 have better postoperative visual acuity recovery.