早期硅油填充联合曲安奈德治疗增生性糖尿病视网膜病变

目的 观察玻璃体手术中使用曲安奈德和早期硅油填充治疗增生性糖尿病视网膜病变的疗效.方法 增生性糖尿病视网膜病变,52例(52眼),行经平坦部玻璃体切除手术.术中使用曲安奈德标识病变组织,将其彻底切除.玻璃体腔内填充硅油.术前最佳矫正视力为0.05.术后随访8个月,观察视力、眼压、视网膜出血和增生情况,并及时补充激光治疗.治疗和随访期内,要求血糖控制在7.0 mmol/L以下的平稳状态.结果 术后8个月,无继发性青光眼或严重增生性反应.观察期内糖尿病视网膜病变无明显再进展表现.结论 在玻璃体切除手术中使用曲安奈德和早期硅油填充,能够有效减少术后并发症,并为及时补充激光治疗提供有利条件,较好的控制糖尿病视网膜病变的进展.

Early silicone oil tamponade combined with triamcinolone acetonide in the treatment of proliferative diabetic retinopathy

Objective To study the curative efficacy of early silicone oil tamponade combined with triamcinolone acetonide for proliferative diabetic retinopathy.Methods Vitrectomy was performed on 52 patients (52 eyes) with proliferative diabetic retinopathy from October 2008 to January 2010.Triamcinolone acetonide was used to identify lesions during surgery.Lesions were completely removed.All the patients received silicone oil tamponade.Preoperative best corrected visual acuity was 0.05.The patients were followed-up for 8 months after treatment and visual acuity,intraocular pressure,hemorrhage and proliferation of retina were observed in the follow-up period.Laser treatment was repeated and the patient blood sugar was controlled.Results 8 months after the surgery,best corrected visual acuity of 29 eyes was above 0.05.There was no secondary glaucoma and severe proliferative response.During the observation period,diabetic retinopathy had no significant further progress.Conclusion Early silicone oil tamponade combined with triamcinolone acetonide for proliferative diabetic retinopathy may effectively reduce postoperative complication and provide favorable conditions for additional laser treatment.