| 玻璃体手术前视网膜光凝对增生型糖尿病视网膜病变患者预后的影响 |
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| 引用本文： | 郝琳娜,毕春潮. 玻璃体手术前视网膜光凝对增生型糖尿病视网膜病变患者预后的影响[J]. 眼科新进展, 2019, 0(2): 176-178. DOI: 10.13389/j.cnki.rao.2019.0040 |
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| 作者姓名： | 郝琳娜 毕春潮 |
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| 作者单位： | 710004 陕西省西安市，西安市第四医院眼科 |
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| 摘 要： | 目的分析玻璃体手术前视网膜光凝对增生型糖尿病视网膜病变患者预后的影响。方法回顾性分析我院因增生型糖尿病视网膜病变行玻璃体手术患者125例(150眼)。根据术前是否行视网膜光凝分为光凝组(30眼)与非光凝组(120眼),术后随访6个月以上;比较手术情况及术后填充介质情况、术后视力提高率、手术时间等。结果本研究150眼均顺利完成玻璃体手术。光凝组患者均无术后再出血发生,而非光凝组中4眼发生术后再出血,且均发生于术后8个月后。光凝组中15眼可见新生血管增生膜,其中11眼术中使用电凝止血;而非光凝组中80眼可见新生血管增生膜,其中70眼术中使用电凝止血;光凝组术中发现或形成视网膜裂孔9眼,视网膜脱离6眼,而非光凝组术中发现或形成视网膜裂孔28眼,视网膜脱离37眼。非光凝组患者硅油填充76眼(63. 3%),光凝组患者硅油填充20眼(66. 7%),两组间填充介质差异有统计学意义,非光凝组患者硅油填充率较高(P <0. 05)。两组患者术后6个月视力大部分较术前有所提高,光凝组视力提高率为70%,非光凝组视力提高率为50%,两组间视力提高率差异有统计学意义,光凝组视力提高居多(P <0. 05)。光凝组手术时间为(85. 83±20. 80)min,非光凝组手术时间为(103. 53±31. 80) min,光凝组手术时间较非光凝组手术时间明显缩短(P <0. 05)。结论糖尿病视网膜病变玻璃体手术前视网膜光凝对预后有积极的影响,可降低玻璃体手术后再出血的发生。
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| 关 键 词： | 糖尿病视网膜病变 视网膜光凝 玻璃体切割术 |
Effect of laser photocoagulation before vitrectomy on prognosis of patients with proliferative diabetic retinopathy |
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| HAO Lin-Na,BI Chun-Chao. Effect of laser photocoagulation before vitrectomy on prognosis of patients with proliferative diabetic retinopathy[J]. Recent Advances in Ophthalmology, 2019, 0(2): 176-178. DOI: 10.13389/j.cnki.rao.2019.0040 |
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| Authors: | HAO Lin-Na BI Chun-Chao |
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| Affiliation: | Department of Ophthalmology，Xi’an No.4 Hospital，Xi’an 710004，Shaanxi Province，China |
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| Abstract: | Objective To analyze the effects of laser photocoagulation before vitrectomy on prognosis of patients with proliferative diabetic retinopathy (PDR).Methods The medical records of 125 patients (150 eyes) with PDR who accepted vitrectomy were retrospectively reviewed.According to whether the laser photocoagulation was performed before vitrectomy,they were divided into group laser (30 eyes) and group non-laser (120 eyes),and the patients were followed up for more than 6 months.The operation,intraocular tamponade,improvement of visual acuity and operation time were analyzed.Results Vitrectomy was successfully performed in 150 eyes in this study.No postoperative rehemorrhage occurred in group laser,but it occurred in 4 eyes in group non-laser,which occurred 8 months later.In group laser,neovascular proliferative membranes were found in 15 eyes,of which 11 were treated with electrocoagulation.In group non-laser,80 presented neovascular proliferative membranes,of which 70 were treated with electrocoagulation.In group laser,retinal breaks were discovered or formed in 9 eyes,and retinal detachment occurred in 6 eyes.In group non-laser,retinal breaks were discovered or formed in 28 eyes,and retinal detachment was occurred in 37 eyes.In group non-laser,76 eyes (63.3%) were filled with silicone oil,while 20 eyes (66.7%) needed this procedure in group laser.The difference of intraocular tamponade between the two groups was statistically significant,and the group laser had a higher probability of filling silicone oil (P<0.05).The visual acuity improvement rate was 70% in group laser,and it was 50% in group non-laser.The difference in terms of visual improvement between the two groups was statistically significant,and the visual acuity in group laser greatly improved (P<0.05).The operation time of the group laser was (85.83±20.80)min,and that was (103.53±31.80)min in group non-laser.The operation time of the group Laser was significantly shorter than that of the non-laser group (P<0.05).Conclusion Laser photocoagulation before vitrectomy has a positive effect on prognosis of proliferative diabetic retinopathy,which can reduce postoperative rebleeding after vitrectomy. |
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| Keywords: | diabetic retinopathy laser photocoagulation vitrectomy |
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