25G+PPV联合术前玻璃体腔注射康柏西普治疗增生型糖尿病视网膜病变

Effect of 25G+pars plana vitrectomy combined with preoperative intravitreal injection of Conbercept on proliferative diabetic retinopathy

目的:探究25G+玻璃体切割术(PPV)联合术前玻璃体腔注射康柏西普治疗增生型糖尿病视网膜病变(PDR)患者的临床疗效,分析其对患者视力、黄斑中心凹厚度(CMT)和血清VEGF水平的影响。方法:回顾性研究。选取2019-10/2022-01本院收治的PDR患者80例87眼,根据治疗方式不同分为对照组(40例45眼,行25G+PPV术治疗)和观察组(40例42眼,行25G+PPV联合术前玻璃体腔注射康柏西普治疗)。比较治疗前,治疗后2wk,1、3mo两组患者的最佳矫正视力(BCVA)、眼压、CMT、血清VEGF水平;随访3mo,观察并记录术后并发症及复发情况。结果:观察组术中出血发生率明显低于对照组(P<0.05)。治疗后,两组患者的BCVA较治疗前改善(P<0.05),CMT、血清VEGF水平下降(P<0.05),眼压无明显变化(P>0.05);治疗1、3mo时,观察组的BCVA值、CMT低于对照组(P<0.05);治疗后3mo时,观察组的血清VEGF水平低于对照组(P<0.05)。治疗后3mo内,观察组的并发症发生率为5%,明显低于对照组的18%(P<0.05);两组患者的PDR复发率无差异(P>0.05)。结论:25G+PPV联合术前玻璃体腔注射康柏西普治疗PDR效果显著,能更好地促进患者术后视力恢复,改善术后黄斑水肿的严重程度,降低血清VEGF水平,并发症发生率低。

AIM:To investigate the clinical effect of 25G+pars plana vitrectomy(PPV)combined with preoperative intravitreal injection of conbercept in the treatment of patients with proliferative diabetic retinopathy(PDR),and analyze the influence on visual acuity,central foveal thickness(CMT)and serum vascular endothelial growth factor(VEGF)level.METHODS:A retrospective study was conducted from October 2019 to January 2022.A total of 80 patients(87 eyes)with PDR were divided into the two groups according to the treatment method,with 40 patients(45 eyes)treated with 25G+PPV in the control group,and 40 patients(42 eyes)treated with 25G+PPV combined with preoperative intravitreal injection of conbercept in the observation group.The two groups were compared in terms of the best corrected visual acuity(BCVA),intraocular pressure,CMT and serum VEGF level before treatment and at 2wk,1 and 3mo after treatment.The patients were followed up for 3mo,with postoperative complications and recurrence recorded.RESULTS:The incidence of intraoperative bleeding in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the BCVA of the two groups was improved(P<0.05),CMT and serum VEGF level were decreased(P<0.05),but there was no significant change in intraocular pressure(P>0.05).The BCVA and CMT of observation group were lower than those of control group at 1 and 3mo after treatment(P<0.05).Serum VEGF level in the observation group was lower than that in the control group at 3mo after treatment(P<0.05).The incidence of complications in observation group(5%)within 3mo after treatment was significantly lower than that in control group(18%;P<0.05).There was no statistically significant difference in recurrence rate of PDR between the two groups(P>0.05).CONCLUSION:With few complications,25G+PPV combined with preoperative intravitreal injection of conbercept is effective in the treatment of patients with PDR,which can better promote postoperative vision recovery,improve macular edema,and reduce serum VEGF level.