白内障人工晶状体植入术后糖尿病性视网膜病变的激光治疗

目的探讨白内障人工晶状体植入术后糖尿病性视网膜病变（diabetic retinopathy．DR）激光光凝治疗的时机及疗效。方法对48例（82眼）行白内障人工晶状体植入术后的糖尿病性视网膜病变患者，在眼底荧光素血管造影（fundus fluorescein angiography，FFA）的指导下，采用Zeiss Visulas532s眼科激光治疗仪予以早期激光光凝。82眼中．65眼行全视网膜光凝（pan—retinal photocoagulation，PRP）治疗，17眼行局部视网膜光凝术，其中12眼黄斑区还行格栅样光凝。术后随访6～18个月，观察其视力、黄斑水肿情况及并发症。结果经光凝治疗后，22眼（26．8％）视力提高，51眼（62．2％1视力无变化，9眼（11．0％）视力下降。在31眼黄斑水肿中，9眼（29．0％）黄斑水肿消退，14眼（45．2％）黄斑水肿部分吸收．8眼（25．8％）黄斑水肿不变，无光凝并发症。结论适时的白内障人工晶状体植入，以及术后早期合理的激光光凝能有效地控制DR的进展，稳定视力。FFA检查是进行正确、有效的激光光凝治疗的重要参考依据。

Laser treatment of diabetic retinopathy after cataract extraction combined with intraocular lens implantation

Objective To investigate the therapeutic effects and the optimal time point for laser photocoagulation on diabetic retinopathy after cataract extraction combined with intraocular lens implantation. Methods Eighty-two eyes with diabetic retinopathy （48 cases） that had undergone cataract extraction combined with in- traocular lens implantation were treated with early laser photocoagulation using a Zeiss Visulas 532s ophthalmic laser. Of the 82 eyes, 65 eyes underwent pan-retinal photoeoagulation, 17 eyes underwent local photocoagulation, and 12 eyes underwent laser grid pattern photoeoagulation to the macula. Visual acuity, macular edema and complications were assessed after the photocoagulation. The period of follow-up was 6-18 months. Results Of the 82 eyes treated with photoeoagulation, visual acuity improved in 22 eyes, remained stable in 51 eyes, and decreased in 9 eyes. Maeular edema was disappeared in 9 eyes, reduced in 14 eyes and showed no change in 8 eyes. No complications were found in any patients. Conclusion Timely cataract extraction combined with intraoeular lens implanta- tion, and rational and early use of laser photoeoagulation are im- portant techniques for controlling the progress of diabetic retinopathy. Fundus fluorescein angiography （FFA） is an important reference for performing laser photocoagulation.