激光治疗白内障超乳术后的糖尿病视网膜病变效果分析  

Laser treatment of diabetic retinopathy after cataract phacoemulsifi

作　　者：哈玲芳[1] 杨红燕[1] 赵玉桐 詹冬梅[1] 

机构地区：[1]宁夏医科大学总医院眼科,宁夏银川750004

出　　处：《宁夏医学杂志》2017年第7期615-617,共3页Ningxia Medical Journal

基　　金：宁夏科技支撑计划项目(2013ZYS102);宁夏医科大学科学研究基金资助重点项目(XZ201410)

摘　　要：目的观察白内障超声乳化摘除合并折叠式人工晶状体植入术后的糖尿病视网膜病变(DR),及时合理的视网膜激光光凝治疗的疗效,分析激光治疗时机及影响因素。方法收集行白内障超声乳化摘除合并折叠式人工晶状体植入术后的DR患者80例156只眼,术后眼底荧光血管造影(FFA)及光学相干断层扫描(OCT)进行DR分期,术后2周视网膜激光治疗,定期随诊,6个月复查对比视力、眼底及黄斑水肿的恢复情况。结果治疗前后对比,视力提高26.3%(41只眼),视力稳定61.5%(96只眼),视力下降12.2%(19只眼),总有效率87.8%(P<0.05);FFA检查视网膜病变改善,显效28.8%(45只眼),有效61.5%(96只眼),无效9.6%(15只眼)(P<0.05);OCT观察黄斑水肿,消退或减轻64.3%(9眼),不变35.7%(5眼)(P<0.05)。结论合并白内障的糖尿病视网膜病变患者,及时行白内障超声乳化摘除合并折叠式人工晶状体植入,术后2周及早行激光视网膜治疗,能有效地控制或延缓DR的进展,改善视网膜状态,对挽救视力尤为重要。Objective To observe the effect of laser treatment on diabetic retinopathy （DR） after cataract phacoemulsifi cation combined with intraocular lens implantation. Methods Total 156 eyes （80 eases） with diabetic retinopathy after cataract phacoemulsifi cation combined with intraocular lens implantation, according to DR staging under the guidance of fundus fluorescence angiography （FFA） and optical coherence tomography （OCT） ,were treated with retinal laser photocoagulation after 2 weeks. The effect of laser treat- ment was observed after 6 months follow - up. Results After 6 months follow - up, visual acuity improved in 41 eyes of all patients （ 26.3 % ）, stabilized in 96 eyes （ 61.5 % ）, and decreased in 19 eyes （ 12.2% ）. The total effectiveness was 87.8 % （ P 〈 0. 05 ）. The results of FFA were used to the effect of laser treatment, according to the new blood atrophied and non - perfusion disappeared. Obvious effects was in 45 eyes （ 28.8% ）, effectiveness was in 96 eyes （ 61.5% ）, and ineffective treatment was in 15 eyes （ 9.6% ） （ P 〈 0.05 ）. According to OCT, macular edema was disappeared or reduced in 64.3% patients, remained unchanged in 35.7% patients （P 〈 O. 05 ）. Conclusion Effective and timely retinal laser photocoagulation therapy after cataract phacoemulsifi cation combined with intraoeular lens implantation two weeks, it can control or delay the advance of DR, and plays an important role in the improvement of visual- function and stabilization of vision.

关 键 词：白内障超声乳化 折叠式人工晶状体植入 糖尿病视网膜病变 视网膜激光治疗 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]