国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
9期
1694-1696
,共3页
糖尿病视网膜病变%玻璃体切割术%新生血管性青光眼%再次手术
糖尿病視網膜病變%玻璃體切割術%新生血管性青光眼%再次手術
당뇨병시망막병변%파리체절할술%신생혈관성청광안%재차수술
diabetic retinopathy%vitrectomy%neovascular glaucoma%secondary surgery
目的：探讨增殖性糖尿病视网膜病变(proliferativediabeticretinopathy,PDR)玻璃体切割术后继发新生血管性青光眼(neovascularglaucoma,NVG)的影响因素及再次手术疗效。<br> 方法：回顾性分析2009-10/2012-12因PDR玻璃体切割术后继发NVG行再次玻璃体手术联合激光光凝治疗的7例7眼患者临床资料。<br> 结果：患者7例首次术前眼压11.21±4.22mmHg。术中激光622~1124点,患者均联合白内障摘除术,5例植入人工晶状体。术后2mo内眼压10.11±3.62mmHg。随访中7例术眼炎症加重,2例玻璃体积血未完全吸收,5例复发玻璃体积血,5例血糖控制欠佳、2例血压控制欠佳。7例均发生NVG。再次手术前眼压41.13±7.76mmHg,术后眼压5例正常,1例睫状体光凝术后正常,1例失访,眼压未控制。<br> 结论：首次术中联合行晶状体手术、激光斑不足、术后出血不吸收及再次出血、眼内炎症及全身因素均可能是PDR术后NVG形成危险因素。再次玻璃体手术联合充分视网膜光凝可有效控制PDR术后NVG的眼压。
目的：探討增殖性糖尿病視網膜病變(proliferativediabeticretinopathy,PDR)玻璃體切割術後繼髮新生血管性青光眼(neovascularglaucoma,NVG)的影響因素及再次手術療效。<br> 方法：迴顧性分析2009-10/2012-12因PDR玻璃體切割術後繼髮NVG行再次玻璃體手術聯閤激光光凝治療的7例7眼患者臨床資料。<br> 結果：患者7例首次術前眼壓11.21±4.22mmHg。術中激光622~1124點,患者均聯閤白內障摘除術,5例植入人工晶狀體。術後2mo內眼壓10.11±3.62mmHg。隨訪中7例術眼炎癥加重,2例玻璃體積血未完全吸收,5例複髮玻璃體積血,5例血糖控製欠佳、2例血壓控製欠佳。7例均髮生NVG。再次手術前眼壓41.13±7.76mmHg,術後眼壓5例正常,1例睫狀體光凝術後正常,1例失訪,眼壓未控製。<br> 結論：首次術中聯閤行晶狀體手術、激光斑不足、術後齣血不吸收及再次齣血、眼內炎癥及全身因素均可能是PDR術後NVG形成危險因素。再次玻璃體手術聯閤充分視網膜光凝可有效控製PDR術後NVG的眼壓。
목적：탐토증식성당뇨병시망막병변(proliferativediabeticretinopathy,PDR)파리체절할술후계발신생혈관성청광안(neovascularglaucoma,NVG)적영향인소급재차수술료효。<br> 방법：회고성분석2009-10/2012-12인PDR파리체절할술후계발NVG행재차파리체수술연합격광광응치료적7례7안환자림상자료。<br> 결과：환자7례수차술전안압11.21±4.22mmHg。술중격광622~1124점,환자균연합백내장적제술,5례식입인공정상체。술후2mo내안압10.11±3.62mmHg。수방중7례술안염증가중,2례파리체적혈미완전흡수,5례복발파리체적혈,5례혈당공제흠가、2례혈압공제흠가。7례균발생NVG。재차수술전안압41.13±7.76mmHg,술후안압5례정상,1례첩상체광응술후정상,1례실방,안압미공제。<br> 결론：수차술중연합행정상체수술、격광반불족、술후출혈불흡수급재차출혈、안내염증급전신인소균가능시PDR술후NVG형성위험인소。재차파리체수술연합충분시망막광응가유효공제PDR술후NVG적안압。
To investigate risk factors and efficacy of reoperation for neovascular glaucoma ( NVG) secondary to vitrectomy in proliferative diabetic retinopathy (PDR). <br> ●METHODS:Seven cases (7 eyes) from October, 2009 to December, 2012 were analyzed retrospectively. All the patients had NVG after the primary vitrectomy for PDR and were performed secondary vitrectomy combined with laser photocoagulation . <br> ●RESULTS: The mean intraocular pressure ( lOP) was (11. 21±4. 22)mmHg before primary surgery. The number of laser spots ranged from 622 to 1124 during the first vitrectomy. Cataract extraction was performed in all 7 cases and intraocular lens was implanted in 5 cases. The mean lOP was (10. 11± 3. 62) mmHg during 2mo after the primary surgery. During follow- up, all the patients had significantly progressive intraocular inflammation. Vitreous hemorrhage was not absorbed completely in 2 cases and recurrent vitreous hemorrhage occurred in the other 5 cases. Five cases had poor glycemic control and the other 2 cases had bad blood pressure control. NVG occurred in all 7cases. The mean lOP was (41. 13 ± 7. 76) mmHg before the secondary surgery. After the secondary surgery, the lOP were under control in 5 cases. For the other 2 cases, the lOP was controlled in one case by transscleral cyclophotocoagulation, another one was lost in follow-up with uncontrolled lOP. <br> ●CONCLUSlON: Primary vitrectomy combined with lens extraction, insufficient laser speckle, unabsorbed and recurrent vitreous hemorrhage, intraocular inflammation and systemic condition may be the risk factors associated with the occurrent of NVG after vitrectomy in PDR. Secondary vitrectomy combined with sufficient retinal photocoagulation is efficiency for NVG after vitrectomy for the PDR.
