玻璃體視網膜手術治療增殖型糖尿病視網膜病變療效觀察

Observational study on the effect of vitreoretinal surgery for PDR

目的回顧性分析和探討玻璃體視網膜手術(Vitreoretinal Surgery,VRS)治療增殖型糖尿病視網膜病變(Proliferative Diabetic Retinopathy,PDR)的臨床療效。方法選擇本院2007年01月~2017年12月37例(43隻眼)糖尿病視網膜病變Ⅳ期~Ⅵ期患者,均採用全麻下顯微玻璃體視網膜手術+/或聯合白内障手術,手術均由同一術者完成,平均隨訪43.29±1.63個月,觀察術後視力及眼部併發症發生情況,分析影響視力預後的相關因素。結果PDRⅣ期、Ⅴ期、Ⅵ期患者VRS術後視力脫殘率均較術前提高,且PDRⅣ期和Ⅴ期患者術後視力脫殘率較PDRⅥ期患者提高明顯。PDRⅣ期患者術後無明顯併發症。PDRⅤ期患者1例1隻眼(4%)術後出現玻璃體出血,1例1隻眼(4%)出現新生血管性青光眼及牽拉性視網膜脫離而失明。PDRⅥ期患者術後1例1隻眼(10%)出現新生血管性青光眼而失明。結論VRS是PDRⅣ期和Ⅴ期積極有效的手術治療方法,術後患者視力明顯改善,併發症少、視力恢復快,是一種安全有效的治療方法。

Objective To investigate the clinical efficacy of VRS For PDR.Methods 37patients(43eyes)with PDR were treated with general anesthesia MVRS+/or combined cataract surgery,the operation was completed by the same surgeon.The patients were followed up with an average of 43.29±1.63 months.observe postoperative visual acuity and ocular complications.Results The rate of visual disability after VRS in patients with PDR stage IV,V,and VI was higher than that before surgery,and the postoperative visual disability rate of patients with PDR stage IV and V was significantly higher than that of patients with PDRVI.There were no postoperative complications in patients with PDRIV.One patient with PDRV(4%)had vitreous hemorrhage after operation.One patient with PDRV(4%)developed neovascular glaucoma and traction retinal detachment and blindness.In the PDRVI stage,One patient(10%)had neovascular glaucoma and blindness.Conclusion Active and effective early surgical intervention for patients with PDR stage IV and V can greatly improve the postoperative visual acuity and postoperative complications are Less,faster recovery.VRS is a safe and effective treatment for PDR.