玻璃体切割术联合激光治疗PDR的疗效观察

目的：探讨玻璃体切割术与激光治疗在增生性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)中的联合应用价值。

方法：选取我院2009-03/2010-03收治的PDR患者89例116眼，随机将患者分为对照组(47例62眼)和研究组(42例54眼)。对照组患者采用玻璃体切割术治疗，研究组患者在对照组患者治疗基础上，联合眼内激光进行治疗。比较分析患者治疗前后最佳矫正视力变化情况， FFA检查结果以及治疗后并发症发生情况。

结果：与治疗前相比，对照组和研究组治疗后最佳矫正视力<0.1的患者比率明显减少，分别为40%和28%，最佳矫正视力0.5～1.0的比率明显提高，分别达到24%和41%，差别均具有统计学意义(P<0.05)。与对照组患者治疗后相比，研究组患者治疗后最佳矫正视力0.5～1.0的比率明显提高，黄斑水肿消退或部分消退比率明显提高，而黄斑水肿加重、视网膜渗漏以及玻璃体再次出血比率明显降低，差别均具有统计学意义(P<0.05)。

结论：玻璃体切割术联合激光是治疗PDR的有效方案，对患者术后视力的提高和并发症的降低具有积极的促进作用。

Observation on the efficacy of vitrectomy with laser for proliferative diabetic retinopathy

AIM: To probe into the clinical application value of vitrectomy with laser in treatment of proliferative diabetic retinopathy.

METHODS: Totally 89 patients(116 eyes)with proliferative diabetic retinopathy in our hospital were selected from March 2009 to March 2010. The patients were divided into control group(47 cases, 62 eyes)and study group(42 cases, 54 eyes)randomly. The patients in control group were treated with vitrectomy. The patients in study group were treated with vitrectomy combined with eye laser. The best-corrected visual acuity(BCVA)and FFA results of the patients before and after treatment, and occurrence of complications after treatment of the patients in two groups were compared and analyzed.

RESULTS: After treatment, the proportion of patients with best-corrected visual acuity <0.1 was reduced significantly in both groups(P<0.05), which were 40% and 28%, respectively. And the proportion of patients with a BCVA ranging from 0.5 to 1.0 was also improved significantly(P<0.05), which reached 24% and 41%, respectively. Compared with control group, the patients in study group after treatment, the rate of BCVA ranging from 0.5 to 1.0 was improved significantly, so did the rates of comprehensive regression of macular edema and partial regression of macular edema. While the rates of macular edema aggravation, retinal leakage and recurrence of vitreous bleeding were reduced significantly, the differences above were statistically significant(P<0.05).

CONCLUSION:Vitrectomy combined with laser treatment is an effective method for patients with proliferative diabetic retinopathy. It has a positive promoting role in improving postoperative visual acuity and reducing the occurrence of complications.