增生性糖尿病视网膜病变合并白内障的联合手术治疗

目的探讨玻璃体手术联合晶状体超声乳化治疗增生性糖尿病性视网膜病变（PDR）合并白内障的临床疗效。方法分析19例（20只限）增生性糖尿病性视网膜病变合并不同程度白内障患者行白内障超声乳化联合玻璃体手术同时进行人工晶状体囊袋内植入的临床资料，观察术后视力改善程度及术中术后并发症。结果随访2—16个月，所有术眼人工晶状体位置良好，手术后20只限中有16只限（80％）视力有不同程度的提高，其中视力提高二行以上13只限（65％）；视力较术前无改善4只限（20％）。术后视力恢复不佳的原因主要与不同程度的糖尿病黄斑病变、视网膜广泛缺血有关。术后并发症包括高眼压、虹膜后粘连、玻璃体腔再出血、视网膜再脱离、晶状体后囊混浊及新生血管性青光眼等。结论玻璃体手术联合白内障超声乳化人工晶状体植入术治疗增生性糖尿病性视网膜病变合并白内障是安全和有效的，可使大多数患者视力改善，且无明显并发症。

Combined surgery in the treatment of proliferative diabetic retinopathy and cataract

Objective To investigate the clinical efficaey of pars plana vitrectomy combined with phacoemulsification in the treatment of proliferative diabetic retinopathy （ PDR ） and cataract. Methods A retrospective review consisted of 20 eyes of 19 patients with proliferative diabetic retinopathy and clinical significant cataract. Pars plana vitrectomy was combined with phacoemulsification and posterior chamber intraocular lens. Postoperative vision and surgical complications were analyzed. Result The postoperative follow-up interval ranged from 2 to 16 months. 16 eyes（80% ） experienced postoperative vision improvement of varying degrees. Vision improved by 2 lines or more in 13 eyes （65% ）, and remained unchanged in 4 eyes （20% ）. Eyes with lower vision were associated with marked diabetic maculopathy and severe ischemia. Postoperative complications included ocular hypertension, posterior synechia of the iris, vitreous hemorrhage, retinal detachment, opacification of the posterior capsule and neovascular glaucoma. Conclusion Phacocmulsification combined with lens implantation during vitreous surgery is safe and effective for PDR and cataract. Combined surgery may improve the visual outcome in the majority of selected eyes without signifieant complication.