玻璃体手术治疗增殖性糖尿病视网膜病变的时机和疗效

山东大学耳鼻喉眼学报

玻璃体手术治疗增殖性糖尿病视网膜病变的时机和疗效

陈放，庄朝荣，赵明，叶东升

扬州大学医学院眼科教研室，江苏扬州 225001

收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-10-24 发布日期:2007-10-24
通讯作者: 陈放

Occasion choice and efficacy of vitrectomy treatment for proliferative diabetic retinopathy

CHEN Fang, ZHUANG Chao-rong, ZHAO ming, YE dong-sheng

Department of Ophthalmology, School of Medicine, Yangzhou University, Yangzhou 225001, Jiangsu, China

Received:1900-01-01 Revised:1900-01-01 Online:2007-10-24 Published:2007-10-24
Contact: CHEN Fang

摘要/Abstract

摘要： 目的探讨玻璃体切割术治疗增殖性糖尿病视网膜病变的时机和疗效。方法回顾186例（242眼）PDR患者资料，123眼行全视网膜光凝术，119眼行玻璃体切割术，对手术时机和治疗效果进行对比分析。术后随访6～40个月。结果 PDRⅣ期、Ⅴ期患者行玻璃体切割手术后视力改善的比例为78.4%，Ⅵ期患者为43.7%；PDRⅣ期患者行全视网膜光凝术治疗后有效率为80.8%，Ⅴ期患者为58.2%；未合并玻璃体出血的Ⅴ期PDR患者，PRP治疗有效率为58.2%，而玻璃体切割术后视力改善者占78.9%。术中并发症主要是医源性裂孔，术后并发症为玻璃体再出血、视网膜脱离、新生血管性青光眼。结论正确把握PDR患者行全视网膜光凝术和玻璃体切割术的时机，才能提高疗效，有效地改善PDR患者的视力。

关键词: 增殖性糖尿病视网膜病变, 玻璃体切割术, 时机

Abstract: Objective To explore the occasion choice and efficacy of vitrecto my for treatment of proliferative diabetic retinopathy(PDR). Methods 186 patients (242 eyes) with PDR were enrolled in this study. Panretinal photocoagulation (PRP) was performed on 123 eyes and vitrectomy on 119 eyes. All were followed up for 6 to 40 months. Results After vitrectomy, visual acuity was improved in 78.4% eyes of the Ⅳ and ⅤPDR groups and 43.7% of the Ⅵ PDR group. After PRP, visual acuity was improved in 80.8% eyes of theⅣ PDR group and 58.2% of the Ⅴ PDR group. For Ⅴ PDR patients without vitreous hemorrhage, the effective rate of vitrectomy treatment was 78.9% while of PRP it was 58.2%. The main operative complication was iatrogenic retinal holes and the postoperative complications were vitreous rehemorrhage, retinal detachment and neovascular glaucoma. Conclusion A suitable operative occasion is important for patients with PDR to ensure good visual acuity.

Key words: Proliferative diabetic retinopathy, Vitrectomy, Occasion choice

中图分类号:

R776.4

陈放,庄朝荣,赵明,叶东升 . 玻璃体手术治疗增殖性糖尿病视网膜病变的时机和疗效[J]. 山东大学耳鼻喉眼学报, 2007, 21(5): 474-476 .

CHEN Fang,ZHUANG Chao-rong,ZHAO ming,YE dong-sheng . Occasion choice and efficacy of vitrectomy treatment for proliferative diabetic retinopathy[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(5): 474-476 .

参考文献

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