个性化玻璃体切割术在糖尿病视网膜病变治疗中的效果研究

Effectiveness of Personalized Vitrectomy in the Treatment of Diabetic Retinopathy

目的探讨个性化玻璃体切割术(pars plana vitrectomy,PPV)在糖尿病视网膜病变治疗中的效果。方法选取2022年2月—2024年2月滨海县人民医院眼科确诊为糖尿病视网膜病变的78例(88眼)患者为研究对象,按照不同的治疗方法分为观察组(41例,47眼)和对照组(37例,41眼)。观察组行个性化PPV,对照组行传统PPV。术后对两组患者进行3个月随访,评估手术前后最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(central retinal thickness,CRT)、术后视网膜浅层血管复合体(superficial vascular complex,SVC)和深层血管复合体(deep vascular complex,DVC)的整体血流密度(vascular density,VD)、中心凹血流密度(foveal vascular density,FVD)以及术后并发症发生率。结果术前,两组BCVA和CRT水平比较,差异无统计学意义(P均>0.05)。术后1周、1个月、3个月,观察组BCVA水平均低于对照组,差异有统计学意义(P均<0.05)。术后1周,两组CRT较术前有升高,术后1个月及3个月CRT降低,且观察组CRT均低于对照组,差异有统计学意义(P均<0.05)。术后,观察组SVC、DVC的整体VD和FVD均高于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论个性化PPV在治疗糖尿病视网膜病变中表现出更优的术后视力恢复和视网膜结构改善效果,且并发症发生率更低。

Objective To investigate the effect of pars plana vitrectomy(PPV)in the treatment of diabetic retinopathy.Methods A total of 78 patients(88 eyes)with diabetic retinopathy diagnosed in the Department of Ophthalmology of Binhai County People's Hospital from February 2022 to February 2024 were selected as the research objects.According to different treatment methods,they were divided into observation group(41 cases,47 eyes)and control group(37 cases,41 eyes).The patients in the observation group were treated with personalized PPV,and the patients in the control group were treated with traditional PPV.The two groups of patients were followed up for 3 months.The best corrected visual acuity(BCVA),central retinal thickness(CRT),vascular density(VD),foveal vascular density(FVD)of superficial vascular complex(SVC)and deep vascular complex(DVC)and the incidence of postoperative complications were evaluated before and after surgery.Results Before operation,there were no significant differences in BCVA and CRT levels between the two groups(all P>0.05).One week,one month and three months after operation,the BCVA levels of the observation group were lower than that of the control group,and the difference were statistically significant(all P<0.05).At 1 week after operation,the CRT of the two groups increased compared with that before operation,and decreased at 1 month and 3 months after operation,the CRT of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).After surgery,the overall VD and FVD of SVC and DVC in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of postoperation complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Personalized PPV shows better postoperative visual acuity recovery and retinal structure improvement in the treatment of diabetic retinopathy,and the incidence of complications is lower.