白内障超声乳化联合玻璃体切割术治疗增生性糖尿病视网膜病变

目的　探讨白内障超声乳化联合玻璃体切割术治疗增生性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）的疗效。方法　选取２００９年１０月至２０１４年５月在我科住院并行白内障超声乳化联合玻璃体切割术的ＰＤＲ患者５６例（７５眼），术后随访６～６０（２８．２４±５．４７）个月。观察术后最佳矫正视力、眼压及并发症等情况。结果　全部患者手术均顺利完成，术后视力提高者７０眼（９３．３３％），视力不变者３眼（４．００％），视力下降者２眼（２．６７％）。术后１个月、３个月及末次随访时眼压分别为（２０．３±９．２）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）、（１７．１±７．３）ｍｍＨｇ、（１９．２±８．５）ｍｍＨｇ，与术前的（１２．７±６．１）ｍｍＨｇ相比，差异均有统计学意义（均为Ｐ＜０．０５）。术后主要并发症包括后囊膜混浊８眼，角膜轻度水肿５眼，前房渗出５眼，玻璃体再出血２眼，视网膜脱离２眼，新生血管性青光眼２眼。结论　白内障超声乳化联合玻璃体切割术治疗ＰＤＲ安全有效，术后视力提高较明显，并发症发生率较低，值得在临床工作中推广应用。

Cataract phacoemulsification combined with vitrectomy for proliferative diabetic retinopathy

Objective To evaluate the efficacy of phacoemulsification combined with vitrectomy in treatment of proliferative diabetic retinopathy ( PDR ) . Methods Fifty-six patients ( 75 eyes) with PDR were chosen in our hospital from October 2009 to May 2014 , all the patients were treated with phacoemulsification combined with vitrectomy. Patients were followed up for (28. 24 +5. 47 ) months (6 - 60 months) . The postoperative best corrected visual acuity , intraocular pressure and complications were observed. Results All patients were successfully completed the operation. The postoperative visual acuity of patients were improved in 70 eyes ( 93. 33% ) . unchanged in 3 eyes (4. 00% ) and decreased in 2 eyes (2. 67% ) . The postoperative intraocular pressure at I month. 3 months and the final follow-up were ( 20. 3 +9. 2 ) mmHg ( I kPa = 7. 5 mmHg) , ( 17. I +7. 3) mmHg and ( 19. 2 + 8. 5 ) mmHg , respectively , compared with the pre-operation ( 12. 7 + 6. I ) mmHg , there were statistical differences ( all P < 0. 05 ) . The main postoperative complications included posterior capsular opacification in 8 eyes, mild corneal edema in 5 eyes, anterior chamber exudation in 5 eyes, vitreous hemorrhage in 2 eyes. Conclusion Cataract phacoemulsification combined with vitrectomy for PDR is safe and effective. The postoperative visual acuity is improved, and the incidence of complication is low. It is worth being popularized in clinical work.