摘要
目的分析术前视网膜光凝对糖尿病视网膜病变(DR)行玻璃体手术患者术中及术后的影响。方法回顾性分析我院2018年1月至2019年7月住院手术的增生型糖尿病视网膜病变(PDR)患者32例(35只眼)。根据术前是否行视网膜光凝分为非光凝组20例(22只眼)与光凝组12例(13只眼),术后随访3~6个月,比较手术时间、术中玻璃体腔介质填充情况、术后出血、术后视力提高情况等。结果本研究32例(35只眼)均顺利完成玻璃体视网膜手术。非光凝组中有1只眼发生术后出血,光凝组无术后出血情况发生。非光凝组中有13只眼可见新生血管膜,光凝组有3只眼可见新生血管膜。非光凝组中发现有牵拉性视网膜脱离5只眼,形成视网膜裂孔3只眼,光凝组中发现有牵拉性视网膜脱离1只眼,形成视网膜裂孔1只眼。非光凝组行硅油填充5只眼,光凝组行硅油填充1只眼,两组间介质填充情况差异有统计学意义(P<0.05)。非光凝组手术时间为(47.41±7.58)min,光凝组手术时间为(37.31±5.25)min,光凝组时间较非光凝组明显缩短,两组之间差异有统计学意义(P<0.05)。术后视力两组患者均较术前有提高,非光凝组视力提高率为54.5%,光凝组视力提高率为76.9%,两组之间的差异有统计学意义(P<0.05)。结论PDR手术前行视网膜激光光凝对患者的预后有积极地影响,可降低玻璃体手术后出血的发生,减少手术并发症,缩短手术时间,对视力的提高有帮助。
Objective To analyze intraoperative and postoperative effects of preoperative retinal photocoagulation on patients undergoing vitreous surgery for diabetic retinopathy.Methods 32 patients(35 eyes)with proliferative diabetic retinopathy in our hospital from January 2018 to July 2019 were retrospectively analyzed.According to whether retinal photocoagulation was performed before surgery,22 eyes in the non-photocoagulation group and 13 eyes in the photocoagulation group were divided into non-photocoagulation group,following up for 3~6 months after surgery,to compare the operation time,intraoperative vitreous cavity media filling,postoperative bleeding,postoperative visual acuity improvement,etc.Results Vitreoretinal surgery was successfully performed in 35 eyes.One eye occurred bleeding in non-photocoagulation group,and no one occurred in the photocoagulation group.13 eyes in the non-photocoagulation group and 3 eyes in the photocoagulation group occurred neovascularization membrane.In the non-photocoagulation group,there 5 eyes occured in traction retinal detachment,3 eyes with retinal hiatus,while 1 eye with traction retinal detachment and 1 eye with retinal hiatus in the photocoagulation group.5 eyes were filled with silicone oil in the non-photocoagulation group,and one eye was filled with silicone oil in the photocoagulation group.The difference of medium filling between the two groups was statistically significant(P<0.05).The operating time of the non-photocoagulation group was(47.41±7.58)min,and that of the photocoagulation group was(37.31±5.25)min.The time of the photocoagulation group was significantly shorter than that of the non-photocoagulation group,and the difference between the two groups was statistically significant(P<0.05).Postoperative visual acuity in both groups was improved compared with that before surgery,with a visual acuity improvement rate of 54.5%in the non-photocoagulation group and 76.9%in the photocoagulation group.The difference between the two groups was statistically significant(P<0.05).Conclusion Laser photocoagulation has a positive effect on the prognosis of patients with proliferative diabetic retinopathy,which can reduce the incidence of hemorrhage after vitreous surgery,reduce surgical complications,shorten surgical time and improve visual acuity.
作者
俞华
刘强
Yu Hua;Liu Qiang(Department of Ophthalmology, Chaohu Hospital of Anhui Medical University, Hefei 238000,China)
出处
《临床眼科杂志》
2020年第2期159-162,共4页
Journal of Clinical Ophthalmology
