摘要
目的比较玻璃体切除术中及术后行全视网膜激光光凝治疗增殖型糖尿病性视网膜病变的临床效果。方法采用单中心前瞻性随机对照研究。对2011年1-12月在广州军区武汉总医院眼科就诊的92例（106只眼）需行玻璃体切除手术的增殖型糖尿病性视网膜病变（PDR），患者按就诊时间单双周编号随机分为两组，A组（60只眼）在玻璃体手术中即行全视网膜光凝（PRP）；B组（46只眼）在术后1月内分3。4次完成PRP。随访6。12月，比较两组治疗效果及并发症。结果A组治疗后视力提高者为50只眼（83．3％），下降者1只眼（1．7％），不变者9只（15．0％）；视力〉0．05者48只眼，较治疗前19只眼明显提高（P〈0．01）。B组中治疗后视力提高者为33只眼（71．7％），视力不变者6只眼（13．O％），视力下降者7只眼（15．2％），治疗后视力妻0．05者32只眼，较治疗前10只眼亦明显提高（P〈0．01）。两组视力提高者相比差异有统计学意义（P〈0．05）。A组中未出现睫状体及脉络膜脱离等并发症，仅7只眼（11．7％）出现持续性浓密玻璃体出血，而B组中玻璃体腔再次出血者18只眼（39．1％），其中10只眼不能完成PRP，两组相比差异有统计学意义（P〈0．05）；新生血管性青光眼的发生A组中为1只眼（2．2％），B组中为4只眼（6．7％），两组相比差异有统计学意义（P〈0．05）。结论玻璃体切除术联合全视网膜激光光凝治疗能有效地治疗增殖型糖尿病性视网膜病变，而术中即完成全视网膜光凝能更有效减少术后出血及新生血管性青光眼等并发症，更有效地改善患者视力，提高疗效。
Objective To compare the clinical effect of panretinal photocoagulation produced during and after vitrectomy surgery to treat proliferative diabetic retinopathy. Methods A monocentric, prospective, placebo-controlled, randomized clinical trial design was used in this study. Ninety-two patients （106 eyes） with proliferative retinopathy planed to receive vitrectomy were divided into 2 groups randomly. Group A （60 eyes） received panretinal photocoagulation （PRP） during surgery and groun B （48 eves） received 3 to 4 sessions nhotocoamllation within a month after surgery The curative effect and complications were compared between those two groups in follow-up days which last for 6-12 months. Results In group A, the final visual acuity increased in 50 eyes （83.3%）, no changed in 9 eyes （15.0%） and decreased in 1 eye （1.7%） after treatment. After treatment, the visual acuity of 48 eyes was more than 0.05. It was significantly higher in comparison to 19 eyes before treatment （P 〈0.01）. In group B, the final visual acuity increased in 33 eyes （71.7%）, no changed in 6 eyes （13.0%） and decreased in 7 eyes （15.3%） after treatment. After treatment, the visual acuity of 32 eyes was more than 0.05. It was significantly higher in comparison to 10 eyes before treatment （P〈0.01）. There were significant differences of improved visual acuity between group A and group B （P〈0.05）. In group A, detachment of ciliary body and choroidal was not observed, continuous and dense vitreous hemorrhage was found in 7 eyes （11.7%）. In group B, continuous and dense vitreous hemorrhage was found in 18 eyes （39.1%）, 10 of 18 eyes could not continue to complete treatment of PRP. There were significant differences of vitreous hemorrhage between group A and group B （P〈0.05）. There were significant differences of neovascular glaucoma between group A and group B （1 eye in group A versus 4 eyes in group B, P〈0.05）. Conclusions Vitrectomy combined with PRP is an effective method in
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第2期120-123,共4页
Chinese Journal of Practical Ophthalmology
