CAJ | 학술논문

目的探讨增生性糖尿病视网膜病变(PDR)玻璃体手术后视力光感或无光感发生的相关因素.设计回顾性、非对照病例系列.研究对象 242例(288眼)因PDR行玻璃体手术的患者.方法回顾2002～2006年因PDR在同仁医院接受玻璃体手术治疗的住院病例,对术后视力为光感/无光感患者的术前糖尿病视网膜病变程度、有无黄斑病变、术后玻璃体再出血、视网膜脱离、新生血管性青光眼和多次手术等因素进行分析,随访1～60个月.主要指标PDR分期、黄斑病变程度、术后并发症.结果根据最后一次随访时视力分组为无光感/光感组(14眼)、有光感组(274眼)(术后视力≥眼前手动).两组在术前严重黄斑病变、术前PDR 6期、术后玻璃体积血、视网膜脱离、新生血管性青光眼、多次手术等方面差异有统计学意义(P值分别为0.048、0.042、0.000、0.048、0.000、0.000).结论术前严重的黄斑病变、PDR6期、术后玻璃体再出血、术后视网膜脱离、术后继发新生血管性青光眼和多次手术是糖尿病视网膜病变术后视力光感/无光感的相关因素.正确的术中处理、减少术后并发症可降低术后光感/无光感的发生率.
목적 탐토증생성당뇨병시망막병변(PDR)파리체수술후시력광감혹무광감발생적상관인소.설계회고성、비대조병례계렬.연구대상 242례(288안)인PDR행파리체수술적환자.방법 회고2002～2006년인PDR재동인의원접수파리체수술치료적주원병례,대술후시력위광감/무광감환자적술전당뇨병시망막병변정도、유무황반병변、술후파리체재출혈、시망막탈리、신생혈관성청광안화다차수술등인소진행분석,수방1～60개월.주요지표PDR분기、황반병변정도、술후병발증.결과근거최후일차수방시시력분조위무광감/광감조(14안)、유광감조(274안)(술후시력≥안전수동).량조재술전엄중황반병변、술전PDR 6기、술후파리체적혈、시망막탈리、신생혈관성청광안、다차수술등방면차이유통계학의의(P치분별위0.048、0.042、0.000、0.048、0.000、0.000).결론 술전엄중적황반병변、PDR6기、술후파리체재출혈、술후시망막탈리、술후계발신생혈관성청광안화다차수술시당뇨병시망막병변술후시력광감/무광감적상관인소.정학적술중처리、감소술후병발증가강저술후광감/무광감적발생솔.
Objective To determine the risk factors of light perception and no light perception appearenee after vitrectomy for pro-liferative diabetic retinopathy (PDR). Design Retrospective, noncomparative case series. Participants 242 patients (288 eyes) who un-derwent vitrectomy for PDR. Methods 288 eyes of participants from 2002 to 2006 at Beijing Tongren Eye Center were reviewed. Cases that had postoperative visual acuity of light perception (LP) and no light perception (NLP) were recorded and PDR stages, traction reti-nal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glauco-ma and re-operations were analyzed. Main Outcome Measures Postoperative complications, PDR stage, macular disorder. Results Subjects were divided into two groups. LP/NLP group included eyes that had postoperative visual acuity of light perception and no light perception (totally 14 eyes in this group). Another group (control group) included eyes that had postoperative visual acuity of hand mo-tion or better (totally 274 eyes in this group). When compared with control group, the LP/NLP group had significantly higher prevalence of PDR 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postopera-tive neovascular glaucoma and reoperation (P value was 0.042, 0.048, 0.048, 0.000, 0.000, 0.000, respectively). Conclusion Risk factors of light perception and no light perception after vitrectomy for PDR include PDR stage 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative, vitreous hemorrhage, postoperative neovascular glaucoma and re-operation. (Ophthalmol CHN, 2009, 18: 251-253)