AIM:To evaluate clinical effect of vitrectomy combined with retinal photocoagulation for proliferative diabetic retinopathy ( PDR) . METHODS:A retrospective analysis 72 patients ( 104 eyes) with PDR who underwent vitrectomy, postoperative fundus fluorescein angiography and retinal photocoagulation within 4wk, from July 2009 to November 2012 in our hospital. All the patients were followed up for more than 12mo, analysising the clinical data of preoperative, postoperative, final corrected vision and the operation complications. RESULTS:The increasing rate of visual acuity after retinal photocoagulation ( the last retinal photocoagulation) within 1wk was 88. 5% (92/104), 1mo was 92. 3% (96/104), 3mo was 90. 4% (94/104) and one eye had neovascular glaucoma, 6mo was 88. 5% (92/104) and one eye had retinal detachment, 12mo was 80. 8%(84/104) and 2 eyes with silicone oil emulsification. Along with the development of diabetic retinopathy, the increasing rate of visual acuity declined, complications of silicone oil eye operation increased, especially in eyes with proliferative diabetic retinopathy in phase five or six. CONCLUSION: Vitrectomy combined with retinal photocoagulation in treatment of PDR is effective and safe. Postoperative fundus fluorescein angiography can have a definite object in view of retinal photocoagulation after vitrectomy, which can reduce excessive photocoagulation and prevent light coagulation deficiencies, while improve the visual acuity effectively and reduce the complications.%目的：评价玻璃体切除联合视网膜光凝治疗增生性糖尿病视网膜病变( proliferative diabetic retinopathy, PDR)的临床效果。 方法：回顾性分析了2009-07/2012-11在我院行玻璃体切除,术后行眼底血管荧光造影后,4 wk内给予视网膜光凝的PDR患者72例104眼,出院后随访12 mo以上,统计分析术前、术后及最终矫正视力、手术并发症等临床资料。 结果：视网膜光凝(最后一次视网膜光凝)后1 wk内视力提高有效率88.5%(92/104),1mo 视力提高有效率92.3%(96/104),3mo视力提高有效率90.4%(94/104),其中1眼发生新生血管青光眼,6 mo 视力提高有效率88.5%(92/104),其中1眼发生视网膜脱离,12mo视力提高有效率80.8%(84/104),并出现2眼硅油乳化,随着糖尿病眼底病变发展,视力提高率下降,硅油眼手术并发症增多,尤其吁期及遇期患眼。 结论：玻璃体切除造影后联合视网膜光凝治疗PDR是安全有效的,玻璃体切除术后进行造影可以有的放矢的进行视网膜光凝,既能减少过度光凝,又能防止光凝不足。可以有效提高患者视力,降低并发症。
展开▼
