晚期糖尿病视网膜病变的玻璃体视网膜手术治疗预后

目的 评价玻璃体视网膜手术治疗晚期糖尿病性视网膜病变（PDR）伴黄斑脱离的临床效果。方法 回顾分析接受玻璃体视网膜手术治疗的60例6期（视网膜全脱离）PDR患者72眼的临床资料。手术方式为玻璃体切割联合或不联合晶状体摘除，术中均注入惰性气体或硅油。视网膜解剖复位的标准以黄斑复位为视网膜复位成功，黄斑未复位为复位失败。手术后行黄斑区OCT检查并随访1年。结果 手术后42眼一次性视网膜复位成功，占58.33%；30眼视网膜复位失败，占41.67%。手术后视力为无光感者3眼，占4.17%，较术前增加3眼；光感者18眼，占25.00%,较术前减少24眼；手动者26眼，占36.11%,较术前增加5眼；数指/10?cm～0.1者20眼，占27.78%,较术前增加11眼；≥0.1者5眼，占6.94%，较术前增加5眼。结论 晚期PDR伴黄斑区脱离的患者行玻璃体视网膜手术难度较大，术后解剖复位率较高，但视功能恢复较差。

Prognosis of vitrectomy for advanced stage proliferative diabetic retinopathy

Objective To evaluate vitreoretinal surgery in the treatment of advanced stage diabetic retinopathy (PDR) from related clinical results. Methods The clinical data of 60 cases, 72 eyes of 6 (out of the whole retina) PDR who had undergone vitreoretinal surgery were retrospectively analyzed. All eyes underwent vitrectomy surgery in combination with or without removal of the crystal and were injected with inert gas or silicone oil. OCT macular surgery was performed in all during a one-year follow-up. Results 42 eyes successfully had the retina reset by one operation, and 30 were failures. Vision that lost its sense was found in 3 eyes post-operatively and none pre-operatively, light perception was in 18 eyes post-operatively and 42 pre-operatively, manual was in 26 eyes post-operatively and 21 pre-operatively, number / 10cm～ 0.1 was in 20 eyes post-operatively and 9 pre-operatively, and ≥ 0.1 in 5 eyes post-operatively and none pre-operatively. Conclusion Vitreoretinal surgery is difficult to perform with a high rate of anatomic reduction, but a poor functional recovery rate for late PDR with a macular area.