高速玻璃体切割在增殖性糖尿病视网膜病变中的应用

目的 探讨高速玻璃体切割(简称为玻切)在PDR手术治疗中的治疗效果及优势.方法 共82例患者86只眼,随机分为两组;所有患者均行闭合式标准三切口玻璃体切割术,其中A组玻切速度为750c/min,B组为1200～1500c/min,负压150mmg.切割玻璃体按照中央-周边顺序进行,术中根据病情联合剥膜、眼内电凝、激光光凝、气液交换、巩膜外冷凝等,无眼内充填或眼内充填C_3F_8或硅油.观察记录两组术中、术后的相关并发症及术后视功能的恢复情况,并将两组间的数据进行比较分析.结果 高速玻切组术中医源性视网膜损伤的发生率及硅油的使用率较普通切速组均有明显的减少,手术时间由A组的1.2h缩短为B组的42.8min,术后视功能恢复较术前有所提高或维持术前水平.结论 高速玻切不仅大大缩短了手术时间,而且能有效地减少PDR术中医源性视网膜裂孔、牵引性视网膜脱离及玻璃体出血等并发症的发生.

High speed vitrectomy in the treatment of proliferative diabetic retinopathy

Objective To evaluate the efficacy and benefit of high speed pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR).Methods Eighty-six patients (86 eyes) with PDR were randomized into 2 groups and all were treated with PPV.The speed of vitrectomy was 750c/min in group A,and 1200-1500c/min in group B.pre-and postoperative best-corrected visual acuity (BCVA) and dilated fun- dus were examined,and the data were analyzed.Results The complication and silicone oil rate of group B was fewer than group A,and the visual function evaluation of group B was better than group A,the surgery time of group B was obviously shorter than group A (from 1.2hr in group A to 48.2 min in Group B).Conclu-sions The high speed PPV could reduce the complications such as the iatrogenic teals,tractional retinal de- tachment and vitreous hemorrhage.