有/无填充物微创玻璃体切割术治疗增生性糖尿病视网膜病变合并牵拉性视网膜脱离的疗效比较

目的　比较有／无填充物的微创玻璃体切割术治疗增生性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）合并牵拉性视网膜脱离的疗效。方法　回顾性分析２０１０年１月至２０１３年１月我院收治的ＰＤＲ合并牵拉性视网膜脱离患者的临床资料，所有患者均采用微创玻璃体切割术治疗，根据术中是否进行玻璃体填充分为无填充物组（Ａ组）和有填充物组（Ｂ组）。术后随访３个月以上，比较两组患者的一般资料（包括性别、年龄、血糖、糖尿病病程等）、手术前后眼压、视力以及术后并发症等。结果　本研究共入组８０例（８０眼）患者，其中Ａ组患者４２例，Ｂ组患者３８例。２组患者术前、术后７ｄ、术后１个月的眼压比较，差异均无统计学意义（均为Ｐ＞０．０５）。２组患者术前、术后３个月的视力比较，差异均无统计学意义（均为Ｐ＞０. ０５），而Ａ组术后１个月时的视力高于Ｂ组，差异有统计学意义（Ｐ＜０．０５）。术后Ａ组２例患者出现低眼压，１例出现玻璃体积血；Ｂ组２例患者出现玻璃体积血，２例出现晶状体混浊，１例出现低眼压；２组患者术后并发症发生率差异无统计学意义（χ２ ＝０．８０２，Ｐ＝０．３７）。结论　ＰＤＲ合并牵拉性视网膜脱离患者采用微创玻璃体手术治疗可取得较好的疗效，且无填充物患者术后视力恢复更快。

Efficacy of minimally invasive vitrectomy with/without filler for PDR combined with tractional RD

Objective To compare the efficacy of mirumally invasive vitrectomy with/without filler for proliferative diabetic retinopathy ( PDR) combined with tractional retinal detachment ( RD) . Methods Clinical data of PDR patients with tractional RD in our hospital from January 2010 to January 2013 were retrospectively analyzed. All patients underwent the minimally invasive vitrectomy , according to with/without filler the patients were divided into two groups : no filler group ( group A) and filler group ( group B) . The general information, including sexual, age, blood glucose, diabetic duration. were compared between two groups , and the preoperative and postoperative intraocular pressure,visual acuity and complication were also compared. Results A total of 80 patients ( 80 eyes) were retrospective analyzed,including 42 cases in group A and 38 cases in group B. There was no significant difference in intraocular pressure before operation and 7 days and I month after operation between two groups ( all P > 0. 05 ) . There was no significant difference in visual acuity before operation and 3 months after operation between two groups ( all P > 0. 05 ) , while the visual acuity at postoperative I month in group A was higher than that in group B (P < 0. 05 ) . In group A, the hypotension appeared in 2 cases .vitreous hemorrhage in I case ;In group B,the hypotension appeared in I case ,vitreous hemorrhage in 2 cases , lens opacification in I cases ;There was no statistical difference in postoperative complications between two groups (X2 = 0. 802 ,P = 0. 37) . Conclusion The minimally invasive vitrectomy for PDR patients with tractional RD have good effects . and the patients without filler have the faster vision recovery.