摘要
目的观察终末期肾病透析患者行微创玻璃体切除术的临床疗效。方法回顾性分析因增生性糖尿病视网膜病或玻璃体积血行微创玻璃体切除术的终末期肾病透析18例（21眼）。其中，腹膜透析组5例（6眼），无肝素血液透析组13例（15眼）。观察两组视力、眼压和术中术后并发症。结果两组患者术后视力较术前明显提高（t=2．589，P=0．018），术后眼压较术前无明显变化（t=-0．476，P=0．639）。差异均无统计学意义（P〉0．05）。术前玻璃体内注射雷珠单抗对两组术中术后并发症及手术时间均无显著影响。结论微创玻璃体切除手术可以提高终末期肾病透析患者伴增生性糖尿病视网膜或伴玻璃体积血的术后视力。与腹膜透析相比，无肝素血液透析不会增加术中术后并发症的风险。
Objective To observe the clinical efficacy of minimally invasive vitrectomy for dialysis patients with end stage renal disease（ESRD）. Methods The clinical data of 21 eyes of 18 dialysis patients with ESRD, who underwent minimally invasive vitrectomy due to proliferative diabetic retinopathy or vitreous hemorrhage were retrospectively reviewed. Six eyes of 5 cases were treated with peritoneal dialysis and 15 eyes of 13 cases were received heparin-free hemodialysis. The visual acuity, intraocular pressure and complications intraoperative and postoperative were observed in two groups. Results The postoperative visual acuity improved in two groups（ t = 2. 589 ,P = 0.018）. The difference of intraocular pressure was not statistically significant between before and after surgery （t = -0. 476 ,P = 0.639）. The difference of visual acuity, intraocular pressure and the rate of intraoperative and postoperative complications were not statistically significant between two groups （ P 〉 0.05 ）. Preoperative intravitreal ranibizumab injection had no influence on complications, surgery time and final visual acuity. Conclusion Minimally invasive vitrectomy can improve the final visual acuity and achieve retinal reattachment for dialysis patients with ESRD, who suffering from vitreous hemorrhage or proliferative diabetic retinopathy. Compared with peritoneal dialysis, heparin-free hemodilysis is unlikely to increase the risk of intra and postoperative complications.
作者
刘亚鲁
刘海洋
李甦雁
Liu Yalu;Liu Haiyang;Li Suyan;Zhang Zhengpei(Department of Ophthalmology,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou Eye Diseases Prevention and Reaserch Institute,Jiangsu 221000,China)
出处
《中华眼外伤职业眼病杂志》
2018年第10期745-748,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
