【摘要】 目的探讨超声乳化和晶体切除术联合玻璃体切除在白内障合并增生性糖尿病视网膜病变(PDR)治疗中的临床疗效。方法分析79例PDR,共105眼,随机分2组,术式1组56只眼,为白内障超声乳化术后,行闭合式三通道玻璃体切除,囊袋内植入后房型人工晶体;术式2组49只眼,为经扁平部玻璃体联合晶体切除术,保留前囊、人工晶体植入前囊上、睫状体沟内。结果术后随访2个月~3年,术式1组视力改善46只眼,占82.1%;术式2组视力改善31只眼,占63.2%,两组术后视力改善眼数比较差异显著(χ2=4.762,P<0.05)。术式1组术后发生虹膜新生血管(INV)1只眼,占1.8%;术式2组术后发生INV 7只眼,占14.3%,两组术后INV发生率比较差异显著(χ2=5.835,P<0.05)。结论在治疗白内障合并PDR患者中,术式1组优于术式2组,其术后并发症和INV的发生率也明显低,可使大多数患者的视力改善。更多还原

【Abstract】 Objective To investigate the efficacy of phacoemulsification or pars plana lensectomy combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract.Methods Seventy-nine cases(105eyes) with PDR and cataract who were undergone two different combined surgery from Feb 2000 to Dec 2003 in our hospital were reviewed,the cases were divided into two groups.Group 1 was treated with the techniques included phacoemulsification combined vitrectomy in 56 eyes,IOL was inserted into the introcapsule via the corneascleral incision.Group 2 was treated with the techniques of lensectomy via the pars plana combined posterior segment surgeries in 49 eyes,the anterior capsule was preserved and the epithelium was suctioned and scraped off,IOL was inserted via the corneascleral incision on the anterior capsule,of which the center area 4.5～(5 mm) in diameter was cut.Results Seventy-nine of 105 eyes after surgery were followed-up for 2 months to 3 years.Postoperatively,There were significant differences between two groups in visual improvement which was achieved in 46 eyes(82.1%) in group1,in 31 eyes(63.3%) in group2,There were significant difference between two groups in visual improvement(χ~2=4.762,P<0.05).Iris neovascularization (INV) occurred in one eye in group 1(1.8%) and 7 eyes in group 2(14.3%) during 1.5～11 months after surgery(χ~2=5.835,P<0.05).Conclusion Phacoemusification and simultaneous introcapsule lens implantation combined with vit-rectomy in the treatment of proliferative diabetic retinopathy and cataract is more effective than pars plana lensectomy combined with vitrectomy.The surgery obviously improves the visual outcome in the majority of selected eyes with less significant complications and occurrence of iris neovascularization(INV).更多还原