摘要
目的探讨术前玻璃体内注射雷珠单抗对增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者行经平坦部玻璃体切割术(pars plana vitrectomy,PPV)效果的影响。方法回顾性分析157例行PPV的PDR患者,分为PPV术前7d行玻璃体内雷珠单抗注射组(A组)及未注射组(B组)。观察并比较两组PPV术中医源性裂孔的发生、填充物应用和术后玻璃体再出血、高眼压及最佳矫正视力情况。结果 A组患者术中医源性裂孔发生占5.61%,术中填充物应用者占38.21%,术后玻璃体再出血者占15.73%,术后高眼压者占43.82%,治疗稳定后最佳矫正视力>0.3者占53.93%;B组患者术中医源性裂孔发生占14.86%,术中填充物应用者占55.41%,术后玻璃体再出血者占33.78%,术后高眼压者占59.45%,治疗稳定后最佳矫正视力>0.3者占21.62%,两组各项指标比较差异均有统计学意义(P=0.04、0.02、0.00、0.04、0.00)。结论 PDR患者PPV术前行玻璃体内雷珠单抗注射能减少术中医源性裂孔的发生及玻璃体腔填充物的应用,降低术后玻璃体腔再出血及高眼压发生的几率,并可使患者获得较好的术后视力。
Objective To investigate the effectiveness of intravitreal injection of ranibizumab on pars plana vitrectomy（PPV） for proliferative diabetic retinopathy（PD R）. Methods A total of 157 patients underwent PPV were analyzed retrospectively,and divided into group A and group B,group A received intravitreal injection of ranibizumab at 7 days before PPV,and group B with no injection. The occurrence of iatrogenic retinal hole,intraocular tamponade,postoperative vitreous re-hemorrhage,postoperative high intraocular pressure and best corrected visual acuity were observed among the two groups. Results In group A,the occurrence of iatrogenic retinal hole and rate of intraocular tamponade application,postoperative vitreous re-hemorrhage and postoperative high intraocular pressure were 5. 61%,38. 21%,15. 73% and 43. 82%,respectively. There were 53. 93% patients with a best corrected visual acuity 〉0. 3. In group B,the occurrence of iatrogenic retinal hole and rate of intraocular tamponade application,postoperative vitreous re-hemorrhage and postoperative high intraocular pressure were 14. 86%,55. 41%,33. 78% and 59. 45%,respectively. There were 21. 62% patients with a best corrected visual acuity 〉0.3. The difference between the two groups was significant in each date（P = 0. 04,0. 02,0. 00,0.04,0. 00）. Conclusion Intravitreal injection of ranibizumab before PPV for PDR can reduce the occurrence of iatrogenic retinal hole and application of intravitreal tamponade,decrease the incidence of postoperative vitreous hemorrhage and high intraocular pressure,and can lead to a better visual acuity.
出处
《眼科新进展》
CAS
北大核心
2016年第3期265-267,共3页
Recent Advances in Ophthalmology
