增生性糖尿病视网膜病变手术后视力光感或无光感发生的相关因素分析  

Risk factors of light perception and no light perception after vitrectomy for proliferative diabetic retinopathy

作　　者：徐军[1] 张彦来[2] 樊文英[1] 魏文斌[1] 翁乃清[1] 张风[1] 卢海[1] 刘宁朴[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730 [2]重庆医科大学第一附属医院眼科,400016

出　　处：《眼科》2009年第4期251-253,共3页Ophthalmology in China

摘　　要：目的探讨增生性糖尿病视网膜病变(PDR)玻璃体手术后视力光感或无光感发生的相关因素。设计回顾性、非对照病例系列。研究对象242例(288眼)因PDR行玻璃体手术的患者。方法回顾2002～2006年因PDR在同仁医院接受玻璃体手术治疗的住院病例,对术后视力为光感/无光感患者的术前糖尿病视网膜病变程度、有无黄斑病变、术后玻璃体再出血、视网膜脱离、新生血管性青光眼和多次手术等因素进行分析,随访1～60个月。主要指标PDR分期、黄斑病变程度、术后并发症。结果根据最后一次随访时视力分组为无光感/光感组(14眼)、有光感组(274眼)(术后视力≥眼前手动)。两组在术前严重黄斑病变、术前PDR 6期、术后玻璃体积血、视网膜脱离、新生血管性青光眼、多次手术等方面差异有统计学意义(P值分别为0.048、0.042、0.000、0.048、0.000、0.000)。结论术前严重的黄斑病变、PDR6期、术后玻璃体再出血、术后视网膜脱离、术后继发新生血管性青光眼和多次手术是糖尿病视网膜病变术后视力光感/无光感的相关因素。正确的术中处理、减少术后并发症可降低术后光感/无光感的发生率。Objective To determine the risk factors of light perception and no light perception appearence after vitrectomy for proliferative diabetic retinopathy （PDR）. Design Retrospective, noncomparative case series. Participants 242 patients （288 eyes） who underwent vitrectomy for PDR. Methods 288 eyes of participants from 2002 to 2006 at Beijing Tongren Eye Center were reviewed. Cases that had postoperative visual acuity of light perception （LP） and no light perception （NLP） were recorded and PDR stages, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glaucoma and re-operations were analyzed. Main Outcome Measures Postoperative complications, PDR stage, macular disorder. Results Subjects were divided into two groups. LP/NLP group included eyes that had postoperative visual acuity of light perception and no light perception （totally 14 eyes in this group）. Another group （control group） included eyes that had postoperative visual acuity of hand motion or better （totally 274 eyes in this group）. When compared with control group, the LP/NLP group had significantly higher prevalence of PDR 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glaucoma and reoperation （P value was 0.042, 0.048, 0.048, 0.000, 0.000, 0.000, respectively）. Conclusion Risk factors of light perception and no light perception after vitrectomy for PDR include PDR stage 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glaucoma and re-operation. （Ophthalmol CHN, 2009, 18： 251-253）

关 键 词：玻璃体手术 糖尿病视网膜病变/外科学 盲/病因学 

分 类 号：R779.6[医药卫生—眼科]