眼内填充在增生型糖尿病视网膜病变合并玻璃体出血玻璃体切割术中的作用  

Role of intraocular tamponade in vitrectomy for proliferative diabetic retinopathy with vitreous hemorrhage

作　　者：周爱意[1] 周陈静[1] 权彦龙[1] 王建明[1] 

机构地区：[1]西安交通大学第二附属医院眼科,陕西省西安市710004

出　　处：《眼科新进展》2016年第9期838-840,共3页Recent Advances in Ophthalmology

基　　金：西安交通大学基金资助(编号:xjj2014080)~~

摘　　要：目的分析眼内填充在增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)合并玻璃体出血玻璃体切割术中的作用。方法回顾性分析2013年5月至2015年5月西安交通大学第二附属医院眼科收治的PDR合并玻璃体出血行玻璃体切割术患者的病例资料。术后随访至少1 a,记录患者一般资料、术前及术后最佳矫正视力、玻璃体内填充物类型、复发性玻璃体出血和视网膜脱离情况。结果 130例(130眼)患者分无填充物、空气填充和硅油填充3组分析,其中无填充物组45例(34.6%)、空气填充组35例(26.9%)和硅油填充组50例(38.5%)。三组患者复发性玻璃体出血分别为:11.1%(5/45)、8.6%(3/35)和10.0%(5/50)。术后1 a内,三组分别有97.8%、94.3%和92.0%患者未发生视网膜脱离。结论 PDR合并玻璃体出血行玻璃体切割术中应用眼内填充物在减少复发性玻璃体出血和避免视网膜脱离方面并没有优势。术中没有视网膜裂孔时应用眼内填充物是不必要的。Objective To analyze the role of intraocular tamponade in vitrectomy for proliferative diabetic retinopathy （PDR） with vitreous hemorrhage. Methods A retrospective analysis of patients who underwent vitrectomy for PDR with vitreous hemorrhage between May 2013 and May 2015 in the department of Ophthalmology, the Second Affiliated Hospital of Medical College of Xi＇ an Jiaotong University was performed, and all patients were followed more than 12 months. The data included age, gender, duration of diabetes, preoperative and postoperative best corrected visual acuity （BCVA） ,type of tamponade, recurrence of vitreous hemorrhage and retinal detachment were observed. Results A total of 130 eyes of 130 patients were included. The patients were analyzed in three groups：No tamponade group （45 cases, 34.5% ）, air tamponade group （35 cases,26.9% ） and silicone oil tamponade group （50 cases,38.5% ）, the rate of recurrent Vitreous hemorrhage in above three groups were 11. 1% （5/45）, 8.6% （3/35） and 10.0% （5/50） ,and the rate of retinal attachment in postoperative 1 year were 97.8% ,94.3% ,and 92.0% ,respectively. Conclusion The use of intraocular tamponade in vitrectomy for PDR with Vitreous hemorrhage is not found to be superior to no tamponade in reducing recurrent vitreous hemorrhage and avoidance retinal detachment. Therefore,the use of intraocular tamponade in eyes without retinal hole is not beneficial.

关 键 词：糖尿病视网膜病变 玻璃体切割术 复发性玻璃体出血 硅油 

分 类 号：R774.1[医药卫生—眼科]