糖尿病性视网膜病变的手术时机及疗效的探讨  

Exploration of the relationship between vitrectomy opportunity and curative effect in proliferative diabetic retinopathy(PDR).

作　　者：徐景美[1] 陈惠茹[2] 徐冰[1] 肖林[1] 张新成[1] 

机构地区：[1]北京铁路总医院眼科,北京100038 [2]北京同仁医院眼科,北京100005

出　　处：《眼外伤职业眼病杂志》2005年第4期266-268,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的　探讨增生性糖尿病性视网膜病变(PDR)的手术时机与疗效的关系。方法　我院1998年8月～2 0 0 3年8月间行玻璃体视网膜手术的增生性糖尿病视网膜病变44例(5 6眼) ,分为增生早期组(糖尿病视网膜病变合并玻璃体积血或既往曾作全视网膜光凝治疗) 2 4眼,增生晚期组(广泛血管纤维膜增生合并牵引性视网膜脱离) 3 2眼,进行回顾性分析。结果　经过3月～3年随访(平均11.3月) ,增生早期组2 4眼均有不同程度的视力改善,0 .3者2 0眼(83 .3 3 % ) ,最佳视力达1.0 ;增生晚期组15眼视力有所提高,最佳视力为0 .4,4眼视力下降(其中两眼继发新生血管性青光眼而黑目蒙)。结论　正确把握糖尿病PDR玻璃体切除术手术时机,同时玻璃体切除术中行足量有效的眼内光凝,才能提高疗效降低糖尿病眼病的致盲率。Objective Toinvestigate the relationship between vitrectomy opportunity and curative effect in proliferative diabetic re tinopat hy. Methods We made a review analysis to 44 PDR patients(56 ey es) received vitrectomy in my hospital from Aug.1998 to Aug.2003.The patients we re divided into proliferative early stage(PES) group containing 24 eyes(PDR with vitreous hemorrhage or treated with panretinal photocoagulation) and proliferat ive later stage (PLS) group containing 32 eyes(extensive fibrovasc ular membraneswith traction retinal detach-ment). Results The patients were followed up about 3～36 months (mean 11.3 months).The visual acuity (VA) of 24 eyes in PES group has improved obviously.The best VA reached 1.0. But the VA of 15 eyes in P LS group has improved in different degree.The best VA is 0.4.The VA of 2 eyes fo rfeited because of secondary glaucoma among the 4 eyes with VA decline. Conclusion To grasp vitrectmy opportunity correctly and use laser coagulation sufficiently and effectively in vitrectmy,we ca n enhance vitrectmy curative effect and decline the blind incidence in PDR patie nts.

关 键 词：糖尿病性视网膜病变 手术时机 疗效 

分 类 号：R779.6[医药卫生—眼科]