玻璃体腔内注射康柏西普辅助25G玻切术治疗PDR的疗效分析

目的：分析术前玻璃体腔内注射抗血管内皮生长因子(vascular endothelial growth factor，VEGF)药物康柏西普对25G玻璃体切割术治疗增生型糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)临床疗效的影响。

方法：选取本院2014-06/2017-05收治并确诊为PDR的患者57例65眼，依据术前是否行玻璃体腔内注药将患者分为注药组和对照组。注药组27例31眼，对照组30例34眼。注药组于术前3d行玻璃体腔内注射康柏西普后行25G微创玻璃体切割术； 对照组仅行25G微创玻璃体切割术。记录并分析两组患者在手术时间、术中出血、电凝止血、医源性视网膜裂孔、硅油填充、术后再出血及最佳矫正视力(best corrected visual acuity，BCVA)等方面的差异。

结果：注药组手术时间明显短于对照组，差异有统计学意义(P<0.05)。注药组医源性视网膜裂孔比例、术中出血比例、电凝止血比例、硅油填充比例、术后再出血比例均少于对照组，差异均有统计学意义(P<0.05)。注药组术后BCVA优于对照组，差异有统计学意义(P<0.05)。

结论：25G玻璃体切割术治疗PDR术前应用康柏西普可有效减少玻璃体切割术中并发症的发生，缩短手术时间，减少术后再出血，改善术后视力。

Effects of vitrectomy with preoperative intravitreal Conbercept for proliferative diabetic retinopathy

AIM: To analyze the clinical effects of preoperative intravitreal Conbercept combined vitrectomy for proliferative diabetic retinopathy(PDR)patients.

METHODS: From June 2014 to May 2017, 57 patients(65 eyes)diagnosed with PDR. The patients were divided into two groups according to whether received preoperative intravitreal conbercept: intravitreal group(27 cases, 31 eyes), control group(30 cases, 34 eyes). Intravitreal group was treated with 0.05mg(0.05mL)conbercept intravitreal injection 3d before vitrectomy, while control group was treated with vitrectomy alone. The overall surgical time, intraoperative bleeding, use of endodiathermy, iatrogenic retinal hole, and silicone oil, postoperative vitreous hemorrhage and the best corrected visual acuity were recorded and analyzed.

RESULTS: The average surgical time of intravitreal group was lower(P<0.05), while intraoperative hemorrhage rate, rate of endodiathermy application, iatrogenic hiatal incidence, rate of silicone oil application, incidences of recurrent vitreous hemorrhage of intravitreal group were lower than those of control group(all P<0.05). Intravitreal group got better postoperative best corrected visual acuity than control group(P<0.05).

CONCLUSION: Intravitreal conbercept for proliferative diabetic retinopathy before 25G vitrectomy decreased surgical complications, reduced the surgical time and postoperative vitreous hemorrhage, and improved the potoperative best corrected visual acuity.