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1. 重庆医科大学附属第一医院眼科
2. 首都医科大学附属北京同仁医院眼科
纸质出版日期:2008,
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[1]张彦来,徐军,刘宁朴.玻璃体手术治疗增殖性糖尿病视网膜病变的预后观察[J].重庆医科大学学报,2008(02):226-228.
ZHANG Yan-lai, et al. Prognosis observation on pars plana vitrectomy for proliferative diabetic retinopathy[J]. Journal of Chongqing Medical University, 2008,(2):226-228.
目的:探讨玻璃体手术治疗增殖性糖尿病视网膜病变(Proliferative diabetic retinopathy
PDR)的疗效。方法:对2002~2006年期间于北京同仁眼科中心接受玻璃体手术治疗的增殖性糖尿病视网膜病变患者242例共288眼的病例资料进行回顾性总结。入选病例根据术前B超及术中眼底所见分为4组:单纯玻璃体积血不合并视网膜脱离组(Ⅰ组)、纤维血管性增殖合并局限性视网膜脱离但未累及黄斑组(Ⅱ组)、视网膜脱离累及黄斑组(Ⅲ组)、增殖性糖尿病视网膜病变行玻璃体手术联合白内障摘除及人工晶状体植入手术组(Ⅳ组)
对以上4组病例手术前/后视力进行统计学分析。结果:Ⅰ组术后视力改善率为84.9%;Ⅱ组术后视力改善率为81.1%;Ⅲ组手术后视力改善率为41.9%;Ⅳ手术后视力改善率为72.0%。Ⅰ组与Ⅱ组的视力改善率经χ2检验无统计学差异(χ2=0.529
P=0.467)
而Ⅲ组视力改善率与Ⅰ组、Ⅱ组、Ⅳ组相比差异有统计学意义(P值分别为0.000 1、0.000 1、0.016)。结论:玻璃体手术是治疗增殖性糖尿病视网膜病变的有效方法
在黄斑未受明显累及时手术治疗将有可能获得较为理想的视力预后。
Objective:To retrospectively review the clinical outcome of pars plana vitrectomy(PPV) for patients with proliferative diabetic retinopathy(PDR).Methods:Data of 242 patients(288eyes) at Beijing Tongren Eye Center from 2002 to 2006 were retrospectively reviewed.According to the B-mode ultrasonic observation before surgery and ocular fundus during surgery
the reviewed cases were divided into four groups: vitreous hemorrhage but without retinal detachments
extensive fibrovascular vitreous membranes with limited traction retinal detachment but not involving the macular area
traction retinal detachment involving the macular
and combined phacoemusification and PPV.Results:Visual improvements were as follows: 84.9% in the group of patients with vitreous hemorrhage without retinal detachments(groupⅠ)
81.1% in the group of patients with extensive fibrovascular vitreous membranes with limited traction retinal detachment but not involving the macular area(groupⅡ)
41.9% in the group of patients with traction retinal detachment involving the macular(groupⅢ)
and 72% in the group of patients with combined phacoemusification and PPV(groupⅣ).The visual improvement between groupⅠ and groupⅡ had no statistical difference through χ2 test(χ2=0.529
P=0.467)
while the visual improvement difference of group
Ⅱand Ⅳ had statistical significance(P=0.000 1
0.000 1
0.016 respectively).Conclusion:Pars plana vitrectomy is an effective treatment for PDR and the treatment may acquire an ideal vision prognosis as the macular area is not obviously involved.
玻璃体手术增殖性糖尿病视网膜病变
vitrectomyProliferative diabetic retinopathy
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