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目的:进一步了解糖尿病视网膜病变(DR)全视网膜光凝术(PRP)后中、长期随诊的激光量和疗效的临床结果。方法:63例增殖期糖尿病视网膜病变(PDR)PRP术后随诊12～132个月(平均43.2个月)的临床资料回顾分析。结果:63例PDR患者PRP术的平均视网膜光凝斑总数975个。视力改变:提高者占24.2％,不变者占35％,下降者占40.8％。主要晚期并发症是程度不等的玻璃体视网膜纤维膜形成及少数病例(4例5只眼)发生1～3次不同程度的玻璃体出血。结论:PDR病例PRP术后中、长随诊的激光量——平均总视网膜光斑数1000个左右;60％的病例视力保持不变或改善,40％的病例视力下降,病情控制。强调了适宜的视网膜光凝范围、适宜的激光波长和适宜的视网膜有效光斑是PRP术成功的关键。还讨论了DR激光治疗后视力下降的因素和主要晚期并发症。
Objective: To further understand the clinical results of medium and long term follow-up of laser quantity and curative effect after diabetic retinopathy (DR) panretinal photocoagulation (PRP). Methods: The clinical data of 63 patients with proliferative diabetic retinopathy (PDR) who were followed up for 12 to 132 months (average 43.2 months) were retrospectively analyzed. Results: The average number of retinal photocoagulation in PRP of 63 patients with PDR was 975. Visual acuity changes: those who increased 24.2%, those who changed 35%, and those who declined 40.8%. The main late complications are varying degrees of vitreoretinal fibrosis and a small number of cases (4 cases 5 eyes) occurred 1 to 3 times different degrees of vitreous hemorrhage. CONCLUSIONS: The number of long-term follow-up laser pulses in PDR patients is about 1000 with an average total number of retina spots. Visual acuity remains unchanged or improves in 60% of cases, and visual acuity and disease control in 40% of cases. Emphasized the appropriate range of retinal photocoagulation, the appropriate laser wavelength and the appropriate effective retinal light spot is the key to the success of PRP. The factors of vision loss and major late complications after DR laser treatment were also discussed.