摘要
目的探究23G和25G玻璃体切除术后对增生性糖尿病视网膜病变(PDR)患者角膜荧光素染色、泪膜变化及炎症反应的影响。方法对2018年1月至2019年1月在我院眼科接受玻璃体切除术的497例(497只眼)PDR患者的临床资料进行了回顾性分析,根据手术方式分观察组(25G玻璃体切除术,256例)和对照组(23G玻璃体切除术,241例)。比较两组患者术前1 d(T0)、术后3 d(T1)、术后7 d(T2)、术后14 d(T3)、术后30 d(T4)角膜荧光素染色(CFS)评分、泪膜破裂时间(BUT)、Schirmer I试验(SIT)值,以及术后1 d炎症反应情况。结果重复测量方差分析显示,时点效应、组间效应、时点与组间的交互效应均会对角膜荧光素染色评分、BUT、SIT水平造成显著影响(P<0.05)。T1、T2、T3、T4时刻观察组较对照组CFS评分显著低(P<0.05);T2、T3时刻两组CFS评分显著升高(P<0.05),T4时刻观察组CFS评分基本恢复正常,而对照组CFS评分仍显著高于术前(P<0.05)。T1、T2、T3、T4时刻观察组较对照组BUT显著长、SIT显著短(P<0.05);T2、T3时刻两组患者BUT显著降低,SIT显著升高,T4时刻观察组BUT、SIT基本恢复正常,对照组BUT显著短于术前,SIT显著长于术前(P<0.05)。观察组(50只眼,19.53%)和对照组(49只眼,20.33%)患者术后1 d炎症>2分的眼数差异不显著(P>0.05)。结论25G玻璃体切除术较23G玻璃体切除术对PDR患者角膜荧光素染色较浅,泪膜稳定性较强,炎症反应无明显差异。
Objective To explore the effects of 23G and 25G vitrectomy on corneal fluorescein staining,tear film changes and inflammation in patients with proliferative diabetic retinopathy(PDR).Methods The clinical data of 497 patients(497 eyes)with PDR who underwent vitrectomy in our hospital from January 2018 to January 2019 were retrospectively analyzed.According to the surgical method,they were divided into the observation group(25G vitrectomy,256 cases)and the control group(23G vitrectomy,241 cases).The corneal fluorescein staining(CFS)scores,tear membrane rupture time(BUT),Schirmer I test(SIT)value were compared between the two groups at presurgical 1 day(T0),and post-surgical 3 days(T1),7 days(T2),14 days(T3)and 30 days(T4).The inflammation reaction was compared on the first day after the surgery.Results The CFS scores of the observation group at T1,T2,T3,and T4 were significantly lower than those in the control group(P<0.05).The CFS scores of both groups at T2,T3 increased significantly(P<0.05),and the CFS scores of the observation group at T4 basically returned to normal,while in the control group the score was still significantly higher than that before the surgery(P<0.05).At T1,T2,T3,and T4,the observation group had significantly longer BUT and significantly shorter SIT than the control group(P<0.05).At T2,T3,the BUT and SIT of the two groups significantly reduced and the SIT significantly increased;at T4,the BUT and SIT of the observation group were basically back to normal,while the BUT of the control group was significantly shorter than that before the surgery,and the SIT was significantly longer than that before the surgery(P<0.05).The observation group(50 eyes,19.53%)and the control group(49 eyes,20.33%)had no significant difference in the number of eyes with inflammation>2 on the first day postsurgically(P>0.05).Conclusions Compared with 23G vitrectomy,25G vitrectomy has less staining of corneal fluorescein,stronger tear film stability,and no significant difference in inflammatory reaction among patients wi
作者
刘媛
杜鹃
杨倩
Liu Yuan;Du Juan;Yang Qian(Department of Ophthalmology,Baoding First Central Hospital,Baoding 071000,China)
出处
《临床眼科杂志》
2021年第3期204-207,共4页
Journal of Clinical Ophthalmology
基金
保定市科学技术和知识产权局课题(17ZF236)。
