532nm绿激光格栅样光凝联合球内注药治疗糖尿病视网膜病变黄斑水肿

目的　观察５３２ｎｍ绿激光格栅样光凝联合球内注药治疗糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）黄斑水肿的临床疗效。方法　选择２０１１年１月至２０１２年１２月我院收治的ＤＲ黄斑水肿患者４０例（８０眼），随机分为治疗组和对照组，每组２０例，对照组给予单纯５３２ｎｍ绿激光格栅样光凝术，治疗组在５３２ｎｍ绿激光格栅样光凝术前给予球内注射Ａｖａｓｔｉｎ（美国Ｇｅｎｅｎｔｅｃｈ公司）。随访期末采用眼底镜及ＦＦＡ观察患者眼底改变情况，采用国际标准视力表检查患者治疗前后视力，同时使用光学相干断层扫描仪检查患者治疗前后的黄斑区视网膜厚度。结果　治疗组治愈２２眼，显效１６眼，无效２眼，总有效率为９５．０％；对照组治愈１７眼，显效１６眼，无效７眼，总有效率为８２．５％；经统计学分析，两组患者的总有效率差异有统计学意义（Ｐ＜０．０５），治疗组疗效好于对照组。治疗前视力比较，两组差异无统计学意义（Ｐ＞０．０５）；与治疗前视力相比，治疗后视力均显著提高（均为Ｐ＜０．０５）；治疗后视力组间比较，治疗组视力好于对照组（Ｐ＜０．０５）。治疗组和对照组治疗前黄斑区视网膜厚度分别为（４２５．４４±３８．２３）μｍ、（４３７．６６±３６．１２）μｍ，两组间差异无统计学意义（Ｐ＞０．０５）；治疗后黄斑区视网膜厚度分别为（１６５．２８±２５．６４）μｍ、（２７５．７８±４２．１４）μｍ，较治疗前均降低（均为Ｐ＜０．０５），且治疗组低于对照组（Ｐ＜０．０５）。结论　相对于单纯激光光凝术，５３２ｎｍ绿激光格栅样光凝联合球内注药治疗ＤＲ更加安全有效，术后视力恢复更快，黄斑水肿吸收更好。

532 run green grid laser photocoagulation combined with intravitreal Avastin injection for diabetic retinopathy macular edema

Objective To discuss the clinical efficacy of 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection for diabetic retinopathy ( DR) macular edema. Methods Forty patients ( 80 eyes) with DR macular edema in our hospital from January 2011 to December 2012 were chosen and divided into two groups ,20 cases in each group , the treatment group received the 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection, and the control group with single 532 nm green grid laser photocoagulation , the postoperative fundus changes were observed by FFA and fundus photography , the visual acuity was checked, and the macular retinal thickness was detected by OCT. Results In the treatment group , the edema was cured in 22 eyes , effective in 16 eyes.ineffective in 2 eyes , the total effective rate was 95. 0% ;In the control group, the edema was cured in 17 eyes , effective in 16 eyes ,ineffective in 7 eyes , the total effective rate was 95. 0% ; Statistical difference was found between two groups (P < 0. 05 ) . There was no difference in preoperative visual acuity between two groups ( P > 0. 05 ) , the postoperative visual acuity in two groups all increased ( all P < 0. 05 ) .the experiment group was better than the control group (P <0. 05 ) . The preoperative macular retinal thickness of two groups were ( 425 . 44 + 38. 23 ) ym , ( 437. 66 + 36. 12 ) ym , which after operation were ( 165 . 28 + 25. 64 ) ym , ( 275. 78 + 42. 14 ) ym , statistical difference was found between two group rn postoperative macular retinal thickness ( P < 0. 05 ) . Conclusion Compared with the single 532 nm green grid laser photocoagulation , the 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection for DR macular edema is more effective and safe with better postoperative visual acuity recovery.