视网膜光凝和玻璃体手术对糖尿病视网膜病变患者眼部功能及并发症的影响

Effects of retinal photocoagulation and vitreous surgery on ocular function and complications in patients with diabetic retinopathy

目的探讨视网膜光凝和玻璃体手术对糖尿病视网膜病变患者眼部功能及并发症的影响。方法选取2020年2月至2021年6月收治的290例糖尿病视网膜病变患者,按是否行视网膜光凝,分为未光凝组30例,光凝组260例,观察2组治疗效果及并发症情况。结果与未光凝组相比,光凝组术中出血量和手术时间均比较短,2组差异具有统计学意义(P<0.05)。光凝组治疗后的眼压、前房深度低于未光凝组,2组比较差异显著(P<0.05)。治疗后,光凝组的LogMAR视力及视野灰度值均低于未光凝组(P<0.05)。治疗后光凝组CAS评分(5.43±2.11)显著低于未光凝组的(7.43±2.21)(P<0.05)。光凝组术后并发症率显著低于未光凝组(P<0.05)。结论糖尿病视网膜病变采用玻璃体切除术前行视网膜光凝术,可减少术中出血,降低并发症,改善患者视力状况和眼部功能,故方案推广意义大。

Objective To investigate the effects of retinal photocoagulation and vitrectomy on ocular function and complications in patients with diabetic retinopathy.Methods A total of 290 patients with diabetic retinopathy admitted from February 2020 to June 2021 were selected and divided into non-photocoagulation group(n=30)and photocoagulation group(n=260)according to the performance of retinal photocoagulation or not.Therapeutic efficacy and complications of the two groups were observed.Results Compared with those in the non-photocoagulation group,the intraoperative blood loss and operation time in the photocoagulation group were significantly shorter(P<0.05).The intraocular pressure and anterior chamber depth in the photocoagulation group were significantly lower than those in the non-photocoagulation group(P<0.05).After treatment,the LogMAR visual acuity and visual field gray value in the photocoagulation group were significantly lower than those in the non-photocoagulation group(P<0.05).After treatment,clinical activity score(CAS)in photocoagulation group was significantly lower than that in non-photocoagulation group(P<0.05).The postoperative complication rate in photocoagulation group was significantly lower than that in non-photocoagulation group(P<0.05).Conclusion Retinal photocoagulation before vitrectomy in patients with diabetic retinopathy can reduce intraoperative blood loss and the incidence of postoperative complications,and improve the visual acuity and ocular function,which deserves to be recommended to clinical application.