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目的 回顾性分析玻璃体切除术治疗增殖型糖尿病性视网膜病变 (proliferative diabetic retinopathy,PDR)的疗效。方法 对 34例 (40眼 ) PDR患者 (IV期 10眼 ,V期 14眼 ,VI期 16眼 )行常规扁平部三切口闭合式玻璃体切除术 ,同时根据病情分别行晶状体超声粉碎、晶状体切除、视网膜复位、眼内激光、硅油注入等。结果 随访 3～ 36 mo(平均 18.5 mo) ,术后脱盲率 47.5 0 % ,脱残率 15 .0 0 % ;术后 16眼角膜上皮愈合迟缓 (40 .0 0 % ) ;5眼发生新生血管性青光眼 (12 .5 0 % ) ;视网膜复位率 6 5 .2 2 % .结论 PDR合并严重玻璃体出血。牵引性视网膜脱离 ,应用玻璃体切除术可有效地清除玻璃体积血 ,缓解视网膜脱离。但因病情严重 ,手术难度大 ,术后视力恢复差 ,术后并发症多。
Objective To retrospectively analyze the therapeutic effect of vitrectomy on proliferative diabetic retinopathy (PDR). Methods 34 patients (40 eyes) with PDR (IV stage, 10 eyes, V stage, 16 eyes) were performed conventional flat three incision closed vitrectomy. At the same time, Retinal reattachment, intraocular laser, silicone oil injection and the like. Results The follow-up ranged from 3 to 36 months (mean 18.5 months). The postoperative blindness rate was 47.5% and the disability rate was 15.0%. The corneal epithelium healed slowly (40.0%) in 16 eyes and the neovascularization occurred in 5 eyes Glaucoma (12.5%) and retinal reattachment rate (52.52%). Conclusions PDR combined with severe vitreous hemorrhage. Traction of retinal detachment, the application of vitrectomy can effectively remove the vitreous hemorrhage, ease retinal detachment. However, due to serious condition, the operation is difficult, poor visual acuity after surgery, postoperative complications.