27G玻璃体切割术治疗糖尿病视网膜病变的疗效分析

Analysis of the efficacy of 27 G vitrectomy in the treatment of diabetic retinopathy

目的比较使用23G、25G、27G玻璃体切割术治疗糖尿病视网膜病变(DR)患者的临床疗效。方法将我院于2020年1月~2021年1月期间行手术治疗的60例DR患者分为三组,每组20例。A组实施27 G玻璃体切割术,B组实施25 G玻璃体切割术,C组实施23 G玻璃体切割术,对三组眼压、视网膜厚度变化、临床活动度评分(CAS)及DR病变早期治疗研究(ETDRS)评分进行比较。结果治疗前,三组眼压水平比较,差异无统计学意义(P>0.05),治疗后三组眼压水平明显降低(P<0.05),A组眼压与B、C组相比波动更小(P<0.05)。治疗前,三组的视网膜厚度比较,差异无统计学意义(P>0.05);治疗后1、3个月,A组的视网膜厚度显著低于B、C组(P<0.05)。治疗前,三组CAS评分比较,差异无统计学意义(P>0.05);治疗后A组CAS评分显著低于B、C组,差异有统计学意义(P<0.05)。治疗前,三组ETDRS评分对比,差异无统计学意义(P>0.05),治疗后三组ETDRS评分明显下降(P<0.05),但治疗后三组ETDRS评分对比,差异无统计学意义(P>0.05)。结论27G玻璃体切割术应用于DR患者治疗中效果较好,能够降低眼压波动,改善视力水平与眼部功能。

Objective To compare the efficacy of 23 G,25 G,and 27 G vitrectomy in the treatment of diabetic retinopathy(DR).Methods 60 patients with DR who underwent surgical treatment in our hospital from January 2020 to January 2021 were divided into three groups,with 20 cases in each group.Group A underwent 27 G vitrectomy,group B underwent 25 G vitrectomy and group C underwent 23 G vitrectomy.The intraocular pressure(iOP)changes,retinal thickness,clinical activity score(CAS)and early treatment of DR lesions(ETDRS)scores among the three groups were compared.Results Before treatment,there was no significant difference in intraocular pressure between the three groups(P>0.05),but after treatment,the intraocular pressure level of the three groups decreased significantly(P<0.05),and the intraocular pressure in group A fluctuated less than that in group B and group C(P<0.05).There was no significant difference in retinal thickness between the three groups before treatment(P>0.05),and the retinal thickness of group A was significantly lower than that of group B and group C at 1 and 3 months after treatment(P<0.05).Before treatment,there was no significant difference in CAS scores between the three groups(P>0.05),and after treatment,the CAS scores of group A were significantly lower than those of group B and group C(P<0.05).Before treatment,there was no significant difference in ETDRS scores between the three groups(P>0.05),and after treatment,the ETDRS scores of the three groups decreased significantly(P<0.05),but there was no significant difference in ETDRS scores between the three groups after treatment(P>0.05).Conclusion 27 G vitrectomy is effective in the treatment of DR patients,which can reduce the fluctuation of iOP and enhance visual acuity and eye function.