玻璃体切除联合超声乳化对PDR患者视力及并发症的影响

目的：观察玻璃体切除联合白内障超声乳化术对增生性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)患者术后视力和并发症的影响。

方法：根据不同术式将95例95眼PDR患者分为观察组(50眼)与对照组(45眼)，观察组行玻璃体切除联合白内障超声乳化术，对照组行玻璃体切除联合晶状体切除术，比较两组患者视力恢复、手术前后眼压变化和手术并发症情况。

结果：两组患者术后视力比术前均显著改善，差异有统计学意义(P<0.05)，且观察组比对照组改善明显，差异有统计学意义(P<0.05)； 两组患者术后1、3、6mo眼压比术前均显著升高，差异有统计学意义(P<0.05)，但两组组间比较差异无统计学意义(P>0.05)； 观察组术后虹膜新生血管形成、囊膜混浊发生率分别为2%、6%，均显著低于对照组的18%、27%，差异有统计学意义(P<0.05)。

结论：玻璃体切除联合白内障超声乳化术能明显改善PDR患者视力，并发症发生率低，虽会导致眼压上升，但经对症处理后可好转。

Visual recovery and complications after vitrectomy combined with phacoemulsification in PDR patients

AIM: To observe the visual recovery and complications in patients with proliferative diabetic retinopathy(PDR)after vitrectomy combined with phacoemulsification.

METHODS: According to different surgical methods, 95 cases(95 eyes)with PDR were divided into the observation group(50 cases)and the control group(45 cases). The observation group was treated with vitrectomy and phacoemulsification, while the control group was treated with vitrectomy and lensectomy. The visual recovery, changes of intraocular pressure before and after surgery and the complications were compared between the two groups.

RESULTS: The visual acuity of the two groups was significantly improved after surgery(P<0.05), and the improvement in observation group was significantly greater than that in the control group(P<0.05). The intraocular pressure of the two groups was increased significantly at 1, 3 and 6mo after surgery(P<0.05), without significant difference between the two groups(P>0.05). The incidence of iris neovascularization and capsule opacification in the observation group(2%, 6%)were significantly lower than those in the control group(18%, 27%; P<0.05).

CONCLUSION: Vitrectomy combined with phacoemulsification can obviously improve the visual acuity of patients with PDR, and the incidence of complications is low. Although it will lead to an increase in intraocular pressure, it can be improved after symptomatic treatment.