TA玻璃体腔注射结合玻璃体切割术治疗PDR

目的:探讨曲安奈德(triamcinolone acetonide,TA)玻璃体腔注射联合玻璃体切割术治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的优点和并发症。方法:对36例48眼具有玻璃体积血的PDR眼,术前5～7d玻璃体腔内注入TA0.1mL(40g/L)后行玻璃体切割术,术中玻璃体腔内注入TA0.3～0.5mL以帮助辨认玻璃体后皮质。结果:炎症反应程度:有4眼(8%)术后瞳孔区可见少量渗出膜,术后5～7d渗出吸收;15眼(31%)房水闪辉,术后3～5d,房水闪辉消失。所有病例都没有发现手术后感染。视力改善情况:39眼(81%)视力较手术前有不同程度提高(大于2行),7眼(15%)手术后视力较术前没有改善。眼压变化:玻璃体腔注入TA前后平均眼压比较其差异没有显著性;手术后1wk内监测平均眼压比术前高,其差异有显著性。手术后第3mo和术前相比,其差异没有显著性。结论:TA玻璃体腔注射联合玻璃体切割在治疗PDR中有较好的效果,临床上没有严重的并发症。

Intravitreal triamcinolone acetonide assisted pars plana virectomy for the treatment of proliferative diabetic retinopathy

AIM:To study the advantages and complications of intravitreal triamcinolone acetonide(TA) assisted pars plana virectomy(PPV) for the treatment of proliferative diabetic retinopathy(PDR).METHODS:The study included 36 case(48 eyes) who underwent PPV for the treatment of PDR with vitreous hemorrhage.They received an intravitreal injection of 0.1mL triamcinolone acetonide 5 to 7 days before operation.During the surgery,0.3 to 0.5mL of TA was injected into the vitreous cavity to visualize the posterior hyaloid.RESULTS:Inflammatory reaction degree:4 eyes(8%) had little exudation membrane in pupil postoperatively and absorbed at postoperative 5-7 days;15 eyes(31%) had aqueous flare which disappleared at about postoperative 3-5 days.Intraocular inflammation was light and no retinal toxicity was found in any eye.The postoperative visual acuity was improved in 39 eyes.The difference of the mean intraocular pressure was not statistically significant after intravitreal TA.During one week after operation,the difference was statistically significant between the mean preoperative and postoperative intraocular pressure.But the difference was not statistically significant after 3 months.CONCLUSION:Intravitreal TA assisted PPV for the treatment of PDR was useful with no serious complications.