玻璃体切割联合白内障手术治疗增生性糖尿病视网膜病变

目的观察玻璃体视网膜手术联合晶状体超声乳化人工晶状体植入术及硅油填充术治疗增生性糖尿病视网膜病变的疗效。方法将63例(67眼)增生性糖尿病视网膜病变患者进行玻璃体视网膜手术联合晶状体超声乳化人工晶状体植入术,剥膜、眼内激光、硅油填充或气体填充等,术后随访3～18个月观察治疗效果。结果单纯玻璃体视网膜手术23眼,联合晶状体超声乳化人工晶状体植入术25眼,术中注入硅油37眼。术后矫正视力不同程度改善52眼,11眼不变,4眼下降。术中眼内出血5眼;术后玻璃体积血2眼,视网膜上出血2眼,一过性高眼压14眼,继发性青光眼2眼,白内障加重或形成13眼,后发性白内障形成6眼。结论玻璃体视网膜手术联合晶状体超声乳化人工晶状体植入术,剥膜、眼内激光、硅油填充或气体填充等治疗增生性糖尿病视网膜病变安全有效,联合手术可避免再次行白内障手术,减少视网膜脱离、白内障、继发性青光眼等并发症的发生率。

Vitrectomy combined with phacoemulsification for proliferative diabetic retinopathy

Objective To observe the efficacy of vitrectomy combined with phacoemulsification,intraocular lens implantation and silicone oil tamponade for proliferative diabetic retinopathy(PDR).Methods Sixty-seven PDR eyes of 63 cases were performed with vitrectomy combined with phacoemulsification,intraocular lens implantation and silicone oil tamponade,and membrane divesting,photocoagulation and silicon oil or gas filling were intraoperative made.The follow-up time was from 3 months to 18 months,the efficacy was observed.Results Single vitrectomy were performed in 23 eyes,vitrectomy combined with phacoemulsification and intraocular lens implantation in 25 eyes,and silicone oil filling in 37 eyes.The corrected visual acuity improved in 52 eyes,unchanged in 11 eyes,decreased in 4 eyes.Intraoperative ocular hemorrhage appeared in 5 eyes,postoperative vitreous hemorrhage in 2 eyes,retinal surface hemorrhage in 2 eyes,transient high intraocular pressure in 14 eyes,cataract aggravated or formation in 13 eyes and after cataract formation in 6 eyes.Conclusion Vitrectomy combined with phacoemulsification,intraocular lens implantation and silicone oil tamponade for PDR is safe and effective,which can successfully avoid the repetition of cataract surgery,and reduce the postoperative complications,such as retinal detachment,cataract and secondary glaucoma.