实用防盲技术
實用防盲技術
실용방맹기술
JOURNAL OF PRACTICAL PREVENTING BLIND
2015年
1期
9-12,15
,共5页
苏安庭%葛正光%金大龙%葛娴
囌安庭%葛正光%金大龍%葛嫻
소안정%갈정광%금대룡%갈한
非接触广角观察系统%23G微创玻璃体切割术%曲安奈德%染色玻璃体切除术%高速玻切%增殖性糖尿病视网膜病变
非接觸廣角觀察繫統%23G微創玻璃體切割術%麯安奈德%染色玻璃體切除術%高速玻切%增殖性糖尿病視網膜病變
비접촉엄각관찰계통%23G미창파리체절할술%곡안내덕%염색파리체절제술%고속파절%증식성당뇨병시망막병변
Non-contact wild-angle viewing system%23-G minimally invasive vitrectomy%Triamcionlohe acetonide%Chromovitrectomy%High-speed vitrectomy%Proliferative diabetic retinopathy
目的:探讨玻璃体视网膜手术治疗增殖性糖尿病视网膜病变(PDR)的临床效果。方法对54例(69只眼)行玻璃体切除术的增殖性糖尿病视网膜病变患者的临床资料进行回顾性分析。所有患者均采用非接触广角观察系统23G微创玻璃体切割术,术中切除中轴部玻璃体后注入TA染色玻璃体,高速玻切除残留玻璃体后皮质及视网膜前膜,行眼内视网膜光凝,如伴有裂孔及视网膜脱离术中行C3F8或硅油填充。术后随访5-23个月平均16.2个月,观察记录最佳矫正视力、眼压、术中术后并发症等发生情况,对记录数据进行统计学分析比较。结果患者69只眼均顺利完成玻璃体手术,20只眼眼内填充硅油,30只眼填充C3F8,19眼平衡盐液填充。Ⅳ期患者术后视力改善率93.7%(15/16),Ⅴ期患者术后视力改善率73.3%(22/30),Ⅵ期患者术后视力改善率47.8%(11/23)。三组术后视力改善率比较,差异有统计学意义(P<0.05)。术后并发症:高眼压、玻璃体出血、视网膜脱离、并发性白内障、新生血管性青光眼、眼球萎缩。结论在非接触广角观察系统下,进行23G微创玻璃体切割术治疗PDR是安全、有效、可行的方法,能够缩短手术时间,恢复视功能,术中应用TA染色玻璃体联合高速玻切,提高手术成功率,值得临床推广应用。
目的:探討玻璃體視網膜手術治療增殖性糖尿病視網膜病變(PDR)的臨床效果。方法對54例(69隻眼)行玻璃體切除術的增殖性糖尿病視網膜病變患者的臨床資料進行迴顧性分析。所有患者均採用非接觸廣角觀察繫統23G微創玻璃體切割術,術中切除中軸部玻璃體後註入TA染色玻璃體,高速玻切除殘留玻璃體後皮質及視網膜前膜,行眼內視網膜光凝,如伴有裂孔及視網膜脫離術中行C3F8或硅油填充。術後隨訪5-23箇月平均16.2箇月,觀察記錄最佳矯正視力、眼壓、術中術後併髮癥等髮生情況,對記錄數據進行統計學分析比較。結果患者69隻眼均順利完成玻璃體手術,20隻眼眼內填充硅油,30隻眼填充C3F8,19眼平衡鹽液填充。Ⅳ期患者術後視力改善率93.7%(15/16),Ⅴ期患者術後視力改善率73.3%(22/30),Ⅵ期患者術後視力改善率47.8%(11/23)。三組術後視力改善率比較,差異有統計學意義(P<0.05)。術後併髮癥:高眼壓、玻璃體齣血、視網膜脫離、併髮性白內障、新生血管性青光眼、眼毬萎縮。結論在非接觸廣角觀察繫統下,進行23G微創玻璃體切割術治療PDR是安全、有效、可行的方法,能夠縮短手術時間,恢複視功能,術中應用TA染色玻璃體聯閤高速玻切,提高手術成功率,值得臨床推廣應用。
목적:탐토파리체시망막수술치료증식성당뇨병시망막병변(PDR)적림상효과。방법대54례(69지안)행파리체절제술적증식성당뇨병시망막병변환자적림상자료진행회고성분석。소유환자균채용비접촉엄각관찰계통23G미창파리체절할술,술중절제중축부파리체후주입TA염색파리체,고속파절제잔류파리체후피질급시망막전막,행안내시망막광응,여반유렬공급시망막탈리술중행C3F8혹규유전충。술후수방5-23개월평균16.2개월,관찰기록최가교정시력、안압、술중술후병발증등발생정황,대기록수거진행통계학분석비교。결과환자69지안균순리완성파리체수술,20지안안내전충규유,30지안전충C3F8,19안평형염액전충。Ⅳ기환자술후시력개선솔93.7%(15/16),Ⅴ기환자술후시력개선솔73.3%(22/30),Ⅵ기환자술후시력개선솔47.8%(11/23)。삼조술후시력개선솔비교,차이유통계학의의(P<0.05)。술후병발증:고안압、파리체출혈、시망막탈리、병발성백내장、신생혈관성청광안、안구위축。결론재비접촉엄각관찰계통하,진행23G미창파리체절할술치료PDR시안전、유효、가행적방법,능구축단수술시간,회복시공능,술중응용TA염색파리체연합고속파절,제고수술성공솔,치득림상추엄응용。
Objetive To observe the clinical effect of vitrectomy for proliferative diabetic retinopathy (PDR).Metods 54cases (69eyes) of PDR were treated with 23-gauge Vitrectomy and non-con-contact wild-angle viewing system (BIOM3). After cut the axial vitreous, TA was used to dye the Vitreous, and then high-speed vitrectomy technique was used to remove the residual vitreous and epiretinal membrane. Then the eyes received laser photocoagulation, In some cases where retinal tear or retinal detachment presented, gas or silicon oil was injected intracocularly .All patients were followed up for 5-23 months, meanly 16.2months. Main outcome measures included the best correcte visual acuity(BCVA), intraocular pressure (IOP), intraoperative and postoperative complications, and the data were statistically analyzed and compared. Results All 69 eyes received vitrectomy, of which silicone oil was tamponaded in 20 eyes, C3F8 was injected in 30eyes, BBS was filled in 19eyes. Stage IV patients had the visual acuity improvement rate of 93.7%(15/16), stage V patients had the rate of 73.2%(22/30), and state VI patients had the rate of 47.8%. There was obvious difference among them (P<0.05). The major postoperative complications included high intraocular pressure, vitreous hemorrhage, retinal detachment, complicated cataract, etc. Conclusion Vitrectomy with 23-gauge micro-invasive vitrectomy and non-contact wild-angle viewing system is safe, effective and practical to treat PDR. It can shorten the time of operation, help the patients recover visual performances.