摘要
目的:评价玻璃体手术联合光凝治疗一组增殖性糖尿病视网膜病变（proliferative diabeticretinopathy,PDR）的效果。方法:对1997年2月至2000年5月之间经玻璃体手术和激光治疗的一组PDR连续的病例进行回顾性研究。结果:共包括79例（男 38,女 41）、104只眼（右 26,左28;双眼 25例）。发现糖尿病史0.5-37a（8.5±6.5a）,发现眼病史15d-8a（1.5±1.5a）。30只眼有视网膜光凝史,但其中26只眼仅光凝一次。手术采用玻璃体切除、新生血管膜切除或切碎、眼内电凝及光凝;对有活动性出血、视网膜脱离或严重缺血的眼,术毕注入硅油（59只眼）。手术中联合白内障摘除63只眼和人工晶状体植入27只眼。术前视力为光感、手动和指数的分别有15、38和22只眼,≥0.02的29只眼（27.8％）。术后视力提高的有84只眼（80.8％）,不变和下降的20只眼（19.2％）。其中,术后视力≥0.1的41只眼（39.4％）。术后2只眼发生新生血管性青光眼。结论:本组多数PDR眼在手术前末得到有效的光凝治疗。经玻璃体手术和光凝,大多数患眼避免了失明或改善了视力。对视网膜脱离、严重缺血和手术中活动性出血的眼,注入硅油可在手术后及早补充视网膜光凝,以阻止病情恶化。眼科学报2001;17:241～244.
Purpose: To evaluate the efficacy of vitreous surgery and photocoagulation for treatment of a series of patients with proliferative diabetic retinopathy(PDR). Methods: A consecutive series of PDR treated with vitrectomy and photocoagulation during February 1997 to May 2000 was retrospectively analyzed.Results: The series included 79 cases (38 male and 41 female) and 104 eyes [oculus dexter(OD), 26; oculus sinister(OS), 28; oculus uterque(OU), 25] with diabetic history for 0.5- 37(8. 5±6.5) years and eye symptoms for 15 days to 1.5 years (1.5±1.5 years). Retinal photocoagulation was performed in 30 eyes with only once in 26 eyes before vitrectomy. Surgical techniques included standard vitrectomy, neovascular membrane peeling and fragmentation, endo - diathermy and endolaser. Silicone oil was injected in 59 eyes with active bleeding, retinal detachment, or severe ischemia. Cataract extraction was done in 63 eyes, of which 27 eyes with intraocular lens implantation. Visual acuity was light perception (LP), hand movement (HM), count fingers(CF), and ≥0.02 in 15, 38, 22, and 29 eyes, respectively before operation. Visual improvement achieved in 84 eyes (80. 8% ) with ≥0. 1 in 41 eyes (39. 4% ) . Visual acuity remained unchanged or decreased in 20 eyes (20. 2% ) . Neovascular glaucoma occurred in two eyes after surgery.Conclusions: Although the series of patients with PDR without sufficient retinal photocoagulation before operation, vitrectomy and endolaser improved the visual outcome in the majority of eyes. Silicone oil injected in eyes with severe ischemia, active bleeding or retinal detachment may provide chance for prompt laser coagulation after surgery in order to prevent progression of PDR. Eye Science 2001; 17: 241 ~ 244.
出处
《眼科学报》
2001年第4期241-244,共4页
Eye Science
