摘要
目的探讨结膜无缝合玻璃体切割系统联合微切口白内障超声乳化在白内障合并增殖型糖尿病视网膜病变患者中的应用效果。方法选取2020年1月至2022年12月南昌大学第二附属医院收治的40例(80眼)白内障合并增殖型糖尿病视网膜病变患者作为研究对象,所有患者均为双眼病变,按照随机数字表法将其分为观察组(20例,40眼)与对照组(20例,40眼)。对照组采用常规玻璃体切割术与白内障超声乳化吸除术,观察组采用结膜无缝合玻璃体切割系统联合微切口白内障超声乳化吸除术。比较两组手术前,术后7 d,术后1、3个月视力水平、眼压水平及内皮细胞数目以及两组术后并发症发生情况。结果两组患者术后7 d,术后1、3个月视力水平高于手术前,差异有统计学意义(P<0.05);手术前、术后7 d、术后1个月,两组患者的视力水平比较,差异无统计学意义(P>0.05);术后3个月,观察组患者的视力水平高于对照组,差异有统计学意义(P<0.05)。术后7 d及术后1、3个月,两组患者的眼压水平低于手术前,差异有统计学意义(P<0.05);手术前,术后7 d,术后1、3个月,两组患者的眼压水平比较,差异无统计学意义(P>0.05)。术后7 d及术后1、3个月,两组患者的内皮细胞数目低于手术前,差异有统计学意义(P<0.05);术后1、3个月,两组患者的内皮细胞数目均高于术后7 d,差异有统计学意义(P<0.05);术后7 d及术后1、3个月,观察组患者的内皮细胞数高于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论结膜无缝合玻璃体切割系统联合微切口白内障超声乳化治疗白内障合并增殖型糖尿病视网膜病变效果显著,可改善患者视力水平,不增加患者术后眼压,且可减少术后内皮细胞的丢失,术后并发症发生率较低。
Objective To explore the effect of conjunctival sutureless vitrectomy system combined with microincision cataract phacoemulsification in patients with cataract and proliferative diabetic retinopathy.Methods Forty patients(80 eyes)patients with cataract and proliferative diabetic retinopathy admitted to the Second Affiliated Hospital of Nanchang University from January 2020 to December 2022 were selected as the study subjects.All patients had lesions in both eyes.They were divided into observation group(20 cases,40 eyes)and control group(20 cases,40 eyes)according to the random number table method.Patients in the control group received routine vitrectomy and phacoemulsification of the cataract.The observation group received a conjunctival sutureless vitrectomy system in combination with phacoemulsification of the cataract with microincision.The visual acuity level,intraocular pressure level and the number of endothelial cells before operation,7 days after operation,1 month after operation and 3 months after operation and the incidence of postoperative complications were compared between the two groups.Results The visual acuity levels at 7 d,1 month and 3 months after surgery were higher than before surgery,and the differences were statistically significant(P<0.05).There was no significant difference in visual acuity between the two groups before surgery,7 d after surgery and 1 month after surgery(P>0.05).Three months after surgery,the visual acuity level of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).At 7 d,1 month and 3 months after operation,the intraocular pressure levels of the two groups were lower than before operation,and the differences were statistically significant(P<0.05).There was no significant difference in intraocular pressure level between the two groups before operation,7 days after operation,1 month after operation and 3 months after operation(P>0.05).At 7 days,1 month and 3 months after operation,the number of endothelial cells in the two groups were lower than before operation,and the differences were statistically significant(P<0.05).At 1 month and 3 months after surgery,the number of endothelial cells in the two groups were higher than those on day 7 after surgery,the differences were statistically significant(P<0.05).At 7 days,1 month and 3 months after surgery,the number of endothelial cells in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Conjunctival sutureless vitrectomy system combined with micro incision phacoemulsification is effective in the treatment of cataract with proliferative diabetes retinopathy.It can improve the visual acuity of patients,not increase the intraocular pressure of patients after surgery,and reduce the loss of endothelial cells postoperation.The incidence of complications after surgery is low.
作者
罗文彬
李国栋
LUO Wenbin;LI Guodong(Department of Ophthalmology,the Second Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang 330006,China)
出处
《中国当代医药》
CAS
2024年第3期58-62,共5页
China Modern Medicine
基金
江西省青年科学基金资助项目(2018ACB21041)。
