作　　者： (周学义）; (李一鸣）; (王美菊）; (张苑苑）; (张历浊）;

机构地区： 秦皇岛视光眼科医院,河北秦皇岛066000

出　　处： 《山东大学耳鼻喉眼学报》 2017年第4期87-89,共3页

摘　　要： 目的研究25+微创玻璃体视网膜手术(VRS)联合玻璃体腔注射雷珠单抗(IVR)治疗增生型糖尿病视网膜病变(PDR)的效果。方法选取行25+微创VRS患者88例(88眼),分为治疗组(n=44)和对照组(n=44)。治疗组术前3~5 d予以IVR治疗后行25+微创VRS;对照组仅行25+微创VRS。比较两组患者术中情况、最佳矫正视力(BCVA)、眼压及术后并发症情况。结果治疗组患者的手术时间、电凝次数、医源性裂孔发生率、玻璃体腔硅油填充率均低于对照组(P<0.05);术后两组患者BCVA均高于术前(P<0.05),术后两组患者眼压均低于术前(P<0.05);术后3个月,治疗组患者玻璃体积血发生率、牵拉性视网膜脱离发生率均低于对照组(P<0.05)。结论行25+微创VRS联合IVR可有效缩短手术时间,降低医源性裂孔和玻璃体出血发生率,降低硅油填充率,有助于PDR患者术后视力的恢复。 Objective To study the effect of 25-gauge minimally invasive vitreoretinal surgery （VRS） in combination with intravitreal ranibizumab （IVR） injections to treat proliferative diabetic retinopathy （PDR）. Methods Eighty- eight PDR patients （88 eyes） who had undergone 25-gauge minimally invasive VRS in our hospital were selected. The patients were divided into a treatment group （ n = 44） and a control group （ n = 44） according to the different preopera- tive treatments they had received. In the treatment group, IVR injections were administered 3 to 5 days prior to the sur- gery （25-gauge minimally invasive VRS）, whereas in the control group, only the 25-gauge minimally invasive VRS was performed. Intraoperative situation, best-corrected visual acuity （BCVA）, intraocular pressure, and postoperative complications were compared between the 2 groups, and statistically analyzed. Results In the treatment group, the op- eration time, frequency of coagulation, incidence of iatrogenic fracture, and the filling rate of silicone oil were all sig- nificantly lower in comparison with the control group （ P 〈 0.05 ）. The BCVA values of the 2 groups postoperatively were significantly higher than the preoperative values （ P 〈 0.05 ）. The intraocular pressure values noted in the 2 groups postoperatively were significantly lower than those observed preoperatively （P 〈 0.05）. Three months following the op- eration, the incidence of vitreous and retinal detachment in the treatment group was significantly lower than that in the control group （ P 〈 0.05 ）. Conclusion The treatment of PDR with 25-gauge minimally invasive VRS in combination with IVR injections can effectively shorten the operation time, reduce the incidence of iatrogenic fracture and vitreous hemorrhage, decrease the rate of silicone oil filling, and aid in the recovery of visual acuity.

关 键 词： 增生型糖尿病视网膜病变 玻璃体视网膜手术 雷珠单抗 视力