增生性糖尿病视网膜病变硅油填充眼白内障摘出人工晶状体植入的手术效果分析  

Analysis of the therapeutic effects of cataract extraction and intraocular lens implantation in silicon oil stored eyes with proliferative diabetic retinopathy

作　　者：李闻思[1] 张风[1] 卢海[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《眼科》2008年第4期239-241,249,共4页Ophthalmology in China

基　　金：北京市科技攻关课题资助(H030930010410)

摘　　要：目的探讨增生性糖尿病视网膜病变(PDR)玻璃体视网膜手术同期联合白内障超声乳化人工晶状体(IOL)植入术与二期硅油取出联合白内障超声乳化吸除IOL植入术的术后炎症反应差异。设计回顾性病例对照研究。研究对象同期或二期行白内障手术的PDR伴牵拉性视网膜脱离或玻璃体积血者接受玻璃体视网膜手术联合硅油填充者91例104眼。方法术后平均随访6个月。同时联合白内障超声乳化吸除IOL植入手术(同期组)52眼,二期行白内障超声乳化吸除IOL植入联合硅油取出手术(二期组)52眼。分析两组间患眼术后视力、前节炎症反应程度的差异。主要指标视力及眼前节炎症反应。结果同期组及二期组患眼术后最佳矫正视力>0.1以上者分别为14/52、8152眼(X^2=-6.87,P=0.07);同期组及二期组患眼术后1周内出现角膜水肿分别为16/52、6/52眼(X^2=11.53,P=0.001);同期组及二期组患眼术后出现角膜后沉着物分别为20152、9/52眼(X^2=5.79.P= 0.019)。结论玻璃体视网膜手术一期联合白内障超声乳化吸除IOL植入术后眼前节炎症反应较严重。Objective To compare the postoperative effect of pars plana vitrectomy, phacoemulsification and intraocular lens （IOL） implantation with silicon oil removed, phacoemulsification and IOL implantation. Design A retrospective case-control study. Participants 91 cases （104 eyes） of proliferative diabetic retinopathy with tractive retinal detachment or vitreous hemorrhage were performed cataract surgery with IOL implantation. Methods All patients were followed up average 6 months, in whom 52 eyes with pars plana vitrectomy, phacoemulsification and IOL implantation （combined group）, and the other 52 eyes with silicon oil removed, phacoemulsification and IOL implantation （sequential group）. The differences of the postoperative visual acuity and inflammatory reactions of the anterior chamber between the two groups were analyzed. Main outcome measures Visual acuity and inflammatory reactions of the anterior chamber. Results There were 14/52 eyes with best corrected visual acuity more than 0.1 in combined group and 8/52 eyes in the sequential group after the surgeries（ X^2=6.87, P=0.07） . Corneal edema happened in 16/52 eyes in combined group and 6/52 eyes in sequential group 1 week after the surgeries （ X^2=11.53, P=0.001）. Keratic precipitate happened in 20/52 eyes in combined group and 9/52 eyes in sequential group after the surgeries （X^2=5.79, P=0.019） .Conclusions The incidence of postoperative anterior chamber inflammation is higher in Phacoemulsification combined with pars plana vitrectomy group.

关 键 词：增生性糖尿病视网膜病变 硅油 白内障 超声乳化 人工晶状体 

分 类 号：R779.66[医药卫生—眼科]