国际眼科杂志
國際眼科雜誌
국제안과잡지
International Eye Science
2015年
9期
1609-1611
,共3页
玻璃体切除术%晶状体切除术%超全视网膜光凝%增殖型糖尿病视网膜病变
玻璃體切除術%晶狀體切除術%超全視網膜光凝%增殖型糖尿病視網膜病變
파리체절제술%정상체절제술%초전시망막광응%증식형당뇨병시망막병변
vitrectomy%lentectomy%extra retinal photocoagulation%proliferative diabetic retinopathy
目的：探讨保留晶状体前囊膜的玻璃体切除术联合术中超全视网膜光凝在增殖型糖尿病视网膜病变( PDR )Ⅵ期合并白内障的临床应用。<br> 方法：回顾性分析2010-01/2013-06于我院收治的PDR遇期合并白内障患者38例45眼,术前视力均为光感至0.1,入院后行保留晶状体前囊膜的玻璃体切除术,术中行超全视网膜光凝( E-PRP ),术毕所有眼均行硅油填充,术后随访12~26mo,观察眼压、视力、眼前节及眼后节情况。结果：术后32眼(71%)视力提高,13眼(29%)视力未提高,BCVA≥0.05的有23眼,较术前有显著差异(χ2=16.80,P<0.01),39眼(87%)视网膜复位良好,2眼(4%)出现硅油依赖眼,7眼(16%)合并视网膜前增殖膜。术后1眼(2%)虹膜新生血管( INV)进展为新生血管性青光眼,4眼INV逐渐消退,但较术前差异无显著性(χ2=1.61,P=0.21)。术后出现一过性高眼压11眼(24%),一过性角膜水肿8眼(18%),前房纤维渗出6眼(13%),虹膜后粘连2眼(4%),前囊膜混浊13眼(29%)。<br> 结论：对于PDRⅥ期合并白内障的患者,保留晶状体前囊膜的玻璃体切除术联合术中超全视网膜光凝是安全有效的,能提高术后视力,有效地复位视网膜。同时可能减少INV的发生。
目的：探討保留晶狀體前囊膜的玻璃體切除術聯閤術中超全視網膜光凝在增殖型糖尿病視網膜病變( PDR )Ⅵ期閤併白內障的臨床應用。<br> 方法：迴顧性分析2010-01/2013-06于我院收治的PDR遇期閤併白內障患者38例45眼,術前視力均為光感至0.1,入院後行保留晶狀體前囊膜的玻璃體切除術,術中行超全視網膜光凝( E-PRP ),術畢所有眼均行硅油填充,術後隨訪12~26mo,觀察眼壓、視力、眼前節及眼後節情況。結果：術後32眼(71%)視力提高,13眼(29%)視力未提高,BCVA≥0.05的有23眼,較術前有顯著差異(χ2=16.80,P<0.01),39眼(87%)視網膜複位良好,2眼(4%)齣現硅油依賴眼,7眼(16%)閤併視網膜前增殖膜。術後1眼(2%)虹膜新生血管( INV)進展為新生血管性青光眼,4眼INV逐漸消退,但較術前差異無顯著性(χ2=1.61,P=0.21)。術後齣現一過性高眼壓11眼(24%),一過性角膜水腫8眼(18%),前房纖維滲齣6眼(13%),虹膜後粘連2眼(4%),前囊膜混濁13眼(29%)。<br> 結論：對于PDRⅥ期閤併白內障的患者,保留晶狀體前囊膜的玻璃體切除術聯閤術中超全視網膜光凝是安全有效的,能提高術後視力,有效地複位視網膜。同時可能減少INV的髮生。
목적：탐토보류정상체전낭막적파리체절제술연합술중초전시망막광응재증식형당뇨병시망막병변( PDR )Ⅵ기합병백내장적림상응용。<br> 방법：회고성분석2010-01/2013-06우아원수치적PDR우기합병백내장환자38례45안,술전시력균위광감지0.1,입원후행보류정상체전낭막적파리체절제술,술중행초전시망막광응( E-PRP ),술필소유안균행규유전충,술후수방12~26mo,관찰안압、시력、안전절급안후절정황。결과：술후32안(71%)시력제고,13안(29%)시력미제고,BCVA≥0.05적유23안,교술전유현저차이(χ2=16.80,P<0.01),39안(87%)시망막복위량호,2안(4%)출현규유의뢰안,7안(16%)합병시망막전증식막。술후1안(2%)홍막신생혈관( INV)진전위신생혈관성청광안,4안INV축점소퇴,단교술전차이무현저성(χ2=1.61,P=0.21)。술후출현일과성고안압11안(24%),일과성각막수종8안(18%),전방섬유삼출6안(13%),홍막후점련2안(4%),전낭막혼탁13안(29%)。<br> 결론：대우PDRⅥ기합병백내장적환자,보류정상체전낭막적파리체절제술연합술중초전시망막광응시안전유효적,능제고술후시력,유효지복위시망막。동시가능감소INV적발생。
AIM: To evaluate the preservation of anterior capsule used in vitrectomy combined with extra retinal photocoagulation for proliferative diabetic retinopathy ( PDR) stage Ⅵ with cataract. <br> METHODS: Retrospective analysis of 38 patients ( 45 eyes) with PDR stage Ⅵ with cataract in our hospital from January 2010 to June 2013, preoperative visual acuity were LP to 0. 1, underwent vitrectomy reserved anterior capsule and intraoperative extra retinal photocoagulation ( E-PRP) with silicone oil tamponade in all eyes. Patients were followed up for 12 ~ 26mo to observe the intraocular pressure, visual acuity, anterior and posterior segment conditions. <br> RESULTS: Postoperatively 32 eyes ( 71%) improved in visual acuity and 13 eyes ( 29%) didn't improve, 23 eyes with BCVA ≥0. 05 there was a significant difference (χ2=16. 80, P<0. 01 ) compared with preoperative. Anatomic retinal attachment was achieved in 39 eyes ( 87%) . There were 2 eyes ( 4%) of silicone oil dependence and 7 eyes (16%) with epiretinal proliferative membrane. One eye ( 2%) was found iris neovascularization ( INV ) and progressed to neovascular glaucoma, 4 INV eyes gradually subsided, but there was no significant difference compared with the preoperative (χ2=1. 61, P=0. 21 ). The postoperative complication incidence of transient intraocular pressure rise, corneal edema, anterior chamber fibrin exudation, posterior synechia and anterior capsule opacification was 24% (11 eyes), 18% (8 eyes), 13% (6 eyes), 4% (2 eyes) and 29% (13 eyes).CONCLUSION: The preservation of anterior capsule invitrectomy combined with E-PRP is safe and effective for patients with PDR stage VI with cataract. It can improve postoperative visual acuity and reattach retina effectively, and may also reduce the incidence of iris neovascularization.
