玻璃体切除联合眼内光凝治疗糖尿病视网膜病变疗效观察

目的探讨玻璃体切除联合眼内光凝治疗糖尿病视网膜病变的临床疗效。方法某院于2009年2月～2011年2月对收治的糖尿病视网膜病变患者采用玻璃体切除联合眼内光凝治疗,术后随访3～6个月,观察所有患者的视力及并发症。结果 94例患者(102只眼)治疗后经过3～6个月随访发现102只眼中有10只眼视力恢复至0.4以上,视力0.02～0.4之间的眼数由术前49只增加到术后80只眼。术前发生视网膜脱离的41只眼在术后均获得复位,随访期间均未复发。该组102只眼中有12只眼在手术中发生医源性视网膜裂孔,经激光光凝封闭。术后有8只眼发生玻璃体积血,其中4只眼经过再次手术后得到治愈,1例在随访期间发生内吸收,而另外3只眼均放弃治疗;在光凝期间有3例出现玻璃体再出血,2只眼内吸收后自行消失,1只眼再次手术治愈;发生暂时性高眼压2眼;并发性白内障l眼,术后经超声乳化联合人工晶体植入后视力提高。结论玻璃体切除联合眼内光凝治疗糖尿病视网膜病变能显著改善手术预后,且术后并发症少,能迅速恢复患者视力,减少失明率,减少患者多次手术的痛苦。

Clinical observation on vitrectomy combined with intraocular photocoagulation for diabetic retinopathy

OBJECTIVE To investigate the curative effect of vitrectomy combined with intraocular photocoagulation for diabetic retinopathy.METHODS The patients with diabetic retinopathy from February 2009-February 2011 in our hospital were treated by vitrectomy combined with intraocular photocoagulation,then followed up for 3-6 months,visual acuity and complications were observed in all the patients.RESULTS In 102 eyes of 94 patients after 3-6 months of follow-up,10 eyes’ visual acuity recovered to more than 0.4,visual acuity of 0.02-0.4 increased from 49 eyes to 80 eyes after operation.Preoperative incidence of retinal detachment in 41 eyes after operation were reseted,no relapse was found during the follow-up period.12 eyes with iatrogenic retinal breaking were treated with laser photocoagulation.There were 8 eyes were found with vitreous hemorrhage after operation,in which 4 eyes were cured after second operation,1 case occurred absorption during follow-up,while the other 3 eyes gave up treatment;during photocoagulation,vitreous hemorrhage occurred in 3 cases,2 eyes disappeared again after the absorption,1 eye was cured after second operation;2 eyes occured with transient high intraocular pressure;visual acuity of l eye with complicated cataract improved,after phacoemulsification combined with intraocular lens implantation.CONCLUSION The vitrectomy combined with intraocular photocoagulation for diabetic retinopathy can significantly improve the prognosis of operation,and have less postoperative complications,can quickly restore vision in patients,reduce the rate of blindness and pain in patients with multiple operation.