微创玻璃体视网膜手术治疗糖尿病视网膜病变所致牵引性视网膜脱离  

Microinvasive vitreoretinal surgery under noncontact wide-field viewing system to treat tractional retinal detachment caused by severe proliferative diabetic retinopathy-

作　　者：姚宜 韩丽荣 闵云花 吴志勇 陈志义 Yao Yi;Han Lirong;Min Yunhua;Wu Zhiyong;Chen Zhiyi(Shanghai Peace Eye Hospital, Shanghai 200437, Chin)

机构地区：[1]上海和平眼科医院,上海200437

出　　处：《中华眼外伤职业眼病杂志》2018年第6期411-414,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价在非接触式广角镜下微创玻璃体视网膜手术治疗严重增生性糖尿病视网膜病变所致牵引性视网膜脱离的效果。方法回顾性分析55例（64只眼）严重增生性糖尿病视网膜病变在非接触式广角镜下完成玻璃体切除视网膜复位手术的临床资料。结果术后随访6～14个月，平均（8．75±3．85）个月，术后60眼视网膜复位，复位率93．75％。术后最佳矫正视力（10gMAR）平均1．89±0．72较术前2．06±1．64明显提高，差异有统计学意义（t=11．484，P=0．022）。其中局限性牵引性视网膜脱离未波及到黄斑者术后视力≥0．05及≥0．3者的百分比均高于广泛牵引性视网膜脱离波及到黄斑者，差异有统计学意义（χ2=5．154，10．234，P〈0．05）。结论在非接触式广角镜下玻璃体视网膜手术治疗严重增生性糖尿病视网膜病变所致牵引性视网膜脱离，视网膜复位率高，可有效改善视功能，黄斑区未受牵引者手术效果优于黄斑区受牵引者。Objective To evaluate the clinial efficacy of microinvasive vitreoretinal surgery under noncontact wide-field viewing systems for the treatment of tractional retinal detachment caused by severe proliferative diabetic retinopathy （PDR）. Methods The data of 64 eyes of 55 patients with severe PDR were analyzed retrospectively. All cases undewent vitrectomy under noncontact wide-field viewing system. Results The follow-up time was 6 - 14 months, average （8.75 ± 3.85 ） months. Retina was reattached in 60 eyes （93.75 % ）. The best corrected visual acuity （ BCVA, log MAR） after operation was improved from 2.06 ± 1.64 to 1.89 -± 0.72, the difference was significant （ t = 11. 484, P = 0. 022）. The BCVA after operation was ≥0.05 or ≥0.3, the percentage of eyes without involving the macular was better than those involving the macular. The difference were statistically significant （χ2 = 5. 154, 10. 234, P 〈 0. 05 ）. Conclusion The microinvasive vitrectomy under noncontact wide-field viewing system is effective for the treatment of tractional retinal detachment caused by severe proliferative diabetic retinopathy. The retinal reattachment rate is high. The visual function is improved.

关 键 词：广角镜 非接触 视网膜病变 糖尿病 增生性 视网膜脱离 牵引性 玻璃体手术 

分 类 号：R779.6[医药卫生—眼科] R587.2[医药卫生—临床医学]