玻切内界膜撕除联合玻璃体腔内注射曲安奈德治疗顽固性黄斑水肿疗效观察  

Vitrectomy with removal of the internal limiting membrane and intravitreai triamcinolone acetonide in the treatment ofrefractory macular edema

作　　者：郝玉华[1] 左建霞[2] 马景学[1] 叶存喜[1] 

机构地区：[1]河北医科大学第二医院眼科,石家庄050000 [2]石家庄市第一人民医院眼科

出　　处：《中国实用眼科杂志》2011年第6期566-568,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价玻切（玻璃体切割）内界膜撕除联合玻璃体腔内注射曲安奈德治疗顽固性黄斑水肿的疗效。方法取18例（22只眼）继发于糖尿病视网膜病变的顽固性黄斑水肿患者行玻切、内界膜撕除联合玻璃体腔内曲安奈德注射治疗，术后随访9～12月，比较患者术前、术后视力改善及黄斑水肿消退情况。结果术后患眼视力和黄斑水肿均明显改善，经治疗的22只眼中15只眼（68．19％）视力提高2行或2行以上，7只眼（31．81％）视力不变；术后9个月时，最佳矫正视力从术前的0．07±0．05增加到0．14±0．06（t=5．26，P=0．000）。OCT结果显示：黄斑水肿明显消退者有20只眼，占90．91％，2只眼水肿消退不明显，占9．09％。黄斑中心凹厚度从术前的（554．18±140．14）μm降至（291．45±95．38）μm（t=7．23，P＝0．000）。其中有6只患眼的黄斑中心凹厚度恢复至正常水平。结论玻切、内界膜撕除联合玻璃体腔内注射曲安奈德治疗顽固性黄斑水肿安全、有效。Objective To evaluate the effect of pars plana vitrectomy with removal of the internal limiting membrane addition to intravitreal triamcinolone acetonide injection in eyes with refractory maeular edema secondary to diabetic retinopathy. Methods Eighteen patients （22 eyes） with refractory maeular edema which was secondary to diabetic retinopathy underwent pars plana vitrectomy with removal of the internal limiting membrane addition to intravitreal tfiamcinolone acetonide injection, Followed-up for 9-12 months. Preoperative and postoperative changes in macular edema and visual acuity were compared. Results The visual acuity and maeular edema were significantly improved after treatment. Visual acuity improved by two or more lines in 15 eyes （68.19%） and remained stable in 7 eyes （31.81%）. The mean preoperative visual acuity was 0.07±0.05. The visual acuity improved to 0.14± 0.06 （t =5.26, P =0.000）. OCT showed that macular edema had weakened significantly in 20 eyes （90.91%）, remained stable in 2 eyes （9.09%）. Central macular thickness was 554.18＋/-140.14p m at baseline and 291.45＋/-95.38g m at 12-month follow-up, showed that maeular edema decreased obviously （t =7.23, P =0.000）. Addition to that, central macular thickness in 6 eyes returned to normal levels. Conclusions Pars plana vitrectomy with removal of the internal limiting membrane addition to intravitreal triamcinolone acetonide injection for refractory macular edema is safe and effective.

关 键 词：糖尿病视网膜病变 黄斑水肿 玻璃体切除 内界膜 

分 类 号：R779.1[医药卫生—眼科]