玻璃体切割联合不同白内障手术治疗增生性糖尿病视网膜病变的临床观察

Clinical efficacy of vitrectomy combined with different cataract surgeries in the treatment of proliferative diabetic retinopathy

目的观察玻璃体切割联合不同白内障手术治疗增生性糖尿病视网膜病变的临床疗效。方法抽取2018年11月至2019年11月周口市中心医院收治的110例增生性糖尿病视网膜病变患者为研究对象,按照随机数字表法将其分为两组。对照组55例患者接受玻璃体切割术联合晶状体切除术治疗,观察组55例接受玻璃体切割术联合超声乳化吸除术治疗。比较两组增生性糖尿病视网膜病变患者的视力改善情况、虹膜新生血管(INV)和囊膜混浊发生率、及其他并发症发生率。结果治疗后,观察组视力改善情况优于对照组(P<0.05)。观察组INV(5.5%,3/55)、囊膜混浊(9.1%,5/55)发生率低于对照组(12.7%,7/55;20.0%,11/55),差异有统计学意义(P<0.05)。观察组褶皱水肿、视网膜牵拉、继发玻璃体出血等其他并发症发生率为10.9%(6/55),低于对照组的29.1%(16/55),P<0.05。结论玻璃体切割术联合晶状体切除术或超声乳化吸除术治疗增生性糖尿病视网膜病变的效果十分显著。其中联合超声乳化吸除术的效果更好,能够更有效的改善患者视力,降低术后并发症发生率。

Objective To observe the clinical efficacy of vitrectomy combined with different cataract surgeries in the treatment of proliferative diabetic retinopathy.Methods A total of 110 patients with proliferative diabetic retinopathy admitted to Zhoukou Central Hospital from November 2018 to November 2019 were selected as the research objects.And the 110 patients were divided into two groups by random number table method.Fifty-five patients in the control group were treated by vitrectomy combined with clear lens extraction;and 55 patients in the observation group received vitrectomy combined with phacoemulsification.The visual acuity improvement,incidences of iris neovascularization(INV)and capsular opacity,and incidence of other complications of the two groups were compared.Results After treatment,the visual acuity improvement in the observation group was significantly better than that of the control group(P<0.05).The incidences of INV and capsule opacity in the observation group were 5.5%(3/55)and 9.1%(5/55),respectively,lower than the 12.7%(7/55)and 20.0%(11/55)of the control group(P<0.05).The incidence of other complications,such as folding edema,retinal traction,secondary vitreous hemorrhage,of the observation group was 10.9%(6/55),lower than the 29.1%(16/55)of the control group(P<0.05).Conclusions The effect of vitrectomy combined with clear lens extraction or phacoemulsification in the treatment of proliferative diabetic retinopathy is very significant.And the combination of vitrectomy with phacoemulsification is more effective,which can more effectively improve the vision of patients,reduce incidence of postoperative complications.