玻璃体视网膜手术对糖尿病视网膜病变激光光凝术后玻璃体积血的疗效探讨

目的:探讨玻璃体视网膜手术对糖尿病视网膜病变(diabetic retinopathy,DR)激光光凝术后玻璃体积血的疗效。方法:对本院2000—2005年因DR而行激光光凝术后发生中度以上玻璃体积血的患者59例62眼行玻璃体视网膜手术,术中补眼底激光。追踪随访6~38个月,平均18个月。结果:玻璃体视网膜手术后0.1以上视力者51眼,占82.26%,0.02以上视力者62眼,占100%,术后视力明显好于术前视力(P<0.01)。术后获得0.5及以上视力者9眼,在积血病程≤6个月组高于>6个月组,但二者之间无统计学意义(P>0.05)。手术并发症包括玻璃体再积血1眼(1.61%)、并发白内障23眼(50%)、暂时性高眼压6眼(9.68%)、角膜水肿6眼(9.68%)、葡萄膜炎4眼(6.45%)及医源性视网膜裂孔5眼(8.07%)。结论:DR激光光凝术后玻璃体积血患者行玻璃体视网膜术后可获得良好的视力,无严重并发症发生。

The Study of the Treatment Effect of Vitreoretinal Surgery for Vitreous Hemorrhage After Laser Photocoagulation for Diabetic Retinopathy

Objective To discuss the treatment effect of vitreoretinal surgery for vitreous hemorrhage after laser photocoagulation for diabetic retinopathy(DR).Methods 62 eyes of 59 DR patients had severe vitreous hemorrhage after laser photocoagulation from 2000 to 2005.All eyes had undergone vitreoretinal surgery with intraoperative laser photocoagulation.Median follow-up was 18 months(range of 6-38 months).Results The visual acuity after vitreoretinal surgery was better than 0.1 in 51 eyes(82.26 %),and better than 0.02 in 62 eyes(100%).After vitreoretinal surgery,the visual acuity was significantly improved(P<0.01).The visual acuity after vitreoretinal surgery was better than 0.5 in 9 eyes,and the proportion was higher in the group of vitreous hemorrhage6months(P>0.05).The complications included vitreous hemorrhage in 1 eye(1.61%),complicated cataract in 23 eyes(50%),temporary ocular hypertension in 6 eyes(9.68%),corneal edema in 6 eyes(9.68%),uveitis in 4 eyes(6.45%),and retinal tear in 5 eyes(8.07%).Conclusion These patients had a distinct improvement in the visual acuity after vitreoretinal surgery without severe complications.