晚期增殖性糖尿病视网膜病变的治疗价值探讨  

The value of vitreoretinal surgery for patients with PDR in late stage

作　　者：李双农[1] 唐仕波[1] 李加青[1] 马红婕[1] 丁小燕[1] 李涛[1] 闫宏[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2006年第3期247-250,共4页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金创新群体项目(30321004);国家自然科学基金(30471849);教育部博士点专项科研基金(教技发中心函[2003]172号)

摘　　要：目的探讨玻璃体视网膜手术对晚期增殖性糖尿病视网膜病变的治疗价值。方法回顾性分析VI期PDR患者33例42眼经标准的玻璃体视网膜手术治疗后的临床资料,对术前后视力,手术并发症及预后等进行重点分析。结果随访35眼,术后视力明显提高,0.05以上者从术前的6/42眼(14.29%)提高到术后的15/35眼(42.86%),其中12眼(80%)视力>0.1。一次手术视网膜复位27/35眼(77.14%),至随访末期(9月)31/35眼(88.57%)。术前伴有视盘萎缩,视网膜血管闭塞,光定位不准,新生血管性青光眼等预后较差,但术后视力仍有11/16(68.8%)眼有不同程度的提高,6/16(37.5%)眼视力≥FC。结论玻璃体视网膜手术可以部分改善晚期PDR患者的视功能,即便是合并严重缺血的病例仍有一定的治疗价值。Objective To investigate the value of viteoretinal surgery for the late proliferative diabetic retinopathy（PDR）. Methods Forty-two eyes with PDR stage VI of 33 patients operated with standard vitreoretinal surgery were analyzed retrospectively. The preoperative and postoperative visual acuity, the complications and the prognosis were analyzed. Results Thirty-five eyes were followed in the final examination. The postoperative visual acuity was increased significantly. The vision of 0.05 or better was obtained from 6/42 eyes（14.29%）to 15/35 eyes （42.86%）,in wtich,12 eyes（80%）were 0.1 or better. The retina was reattachment in 27（77.14%）with once operation and in 31（88.57%）of 35 eyes with last reattachment in27（77.14%）with once operation and in 31（88.57%）of 35 eyes with last examination. The prognosis was worse when the eyes were associated with papillary atrophy,retinal vessels closure,bad light position, neovascularized glaucoma. However, the postoperative visual acuity was still increased in 11（68.8%）16 eyes,and 6（37.5%）16 eyes were figure count or better. Conclusions The visual acuity of eyes with late PDR can be improved at a certain degrees after vitreoretinal surgery. Even for the patients with severe retinal ischsis,this surgery still has its own value.

关 键 词：增殖性糖尿病视网膜病变 玻璃体视网膜手术 视力 预后 

分 类 号：R587.2[医药卫生—内分泌] R493[医药卫生—内科学]