伴有虹膜新生血管的增殖性糖尿病视网膜病变手术治疗预后观察

目的 探讨伴有虹膜新生血管的增殖性糖尿病视网膜病变玻璃体手术治疗预后.方法 回顾性总结2002～2006年因增殖性糖尿病视网膜病变接受玻璃体手术治疗的住院病例,选择其中随访1月以上的病例入选,对术前伴有虹膜新生血管(INV)的患者记录其临床病程、糖尿病分型、年龄、性别、术前与术后视力、晶体状况、手术方式、PRP情况、以及治疗前后眼压和INV变化情况等并进行总结.结果 其中随访1月以上的病例242例288只眼,最长随访时间60个月.患者年龄(20～76)岁,平均年龄(53.5±10.4)岁.在入选的242例患者288只眼中,有8例8只眼术前发现INV,其中4只眼发展为新生血管性青光眼(NVG).在玻璃体手术联合眼内光凝术后,INV均有不同程度减退,大多发生在术后2周内.其中7例INV消失,1例随访期内未见INV消失.在随访期间,4例NVG患者眼压均药物控制(<21 mmHg).随访期间,5例患者术后视力较术前提高,2例视力不变,1例视力下降,所有病例术后视力均在0.02以上.结论 及时的玻璃体手术联合眼内光凝有可能促进糖尿病性INV的消退,并使NVG的眼压得以控制.

Prognosis of vitrectomy for proliferative diabetic retinopathy With iris neovascularization

Objective To determine the prognosis of vitrectomy for proliferative diabetic retinopathy (PDR)with iris neovascularization(INV).Methods Vitrectomies performed on eyes with proliferative diabetic retinopathy during 2002 to 2006 at Beijing Tongren Eye Center were retrospectively reviewed.Cases with iris neovascularization were recorded and analyzed.Results Of the 288 vitrectomies,preoperative INV was present in 8 eyes,including 4 eyes which had developed neovascular glaucoma(NVG).After vitrectomy combined with endolaser photocoagulation,INV diminished in 7 eyes,remained stable in 1 eye at the last visit of follow-up.Most of INV diminished within 2 weeks.During follow-up period,IOP of 4 eyes with NVG was well-controlled(<21mmHg)with the help of anti-glaucoma drugs.Visual acuity improved in 5 eyes,decreased in 1 eye.and stabilized in 2 eyes.All of 8 eyes had vision of greater than 0.02.Conclusion Vitrectomy combined with endolaser pan-retinal photocoagulation can effectively treat patients with INV induced by proliferative diabetic retinopathy,and can help control the IOP for patients with NVG.