【摘要】 目的:观察玻璃体切割和超声乳化、人工晶状体植入联合手术治疗增殖性糖尿病性视网膜病变的疗效。方法:回顾性分析91例117只眼行玻璃体切割和超声乳化、人工晶状体植入联合手术治疗增殖性糖尿病性视网膜病变患者的临床资料。所有病例随访8~64个月(平均25个月)。结果:视网膜裂孔是术中最常见的并发症(19%),22%的病例术后局部纤维素性渗出。术后6个月内,7%的病例发生青光眼,2%发生虹膜红变。10%的病例需行二次手术:由于出血行眼内灌洗术(n=3),术后7 d内由于局部再次出血行硅油置换术(n=1),眼内气体吸收后由于网膜脱离行硅油注入术(n=1),由于迟发性玻璃体出血行眼内灌洗术(7~13个月)(n=4)。50%的二次手术在术后3个月内进行。结论:玻璃体切割和超声乳化、人工晶状体植入联合手术治疗增殖性糖尿病性视网膜病变安全、有效,增殖性糖尿病性视网膜病变合并有晶状体混浊或术后晶状体混浊加重者可考虑行玻璃体切割和超声乳化、人工晶状体植入联合手术。更多还原

【Abstract】 Objective:To evaluate the results of combined vitrectomies and intraocula rlrns implantations in cases of proliferative diabetic retinopathy.Methods: Data from procedures on 117 eyes(91 patients) undergoing combined pars plana vitrectomy,phacoemulsification,and intraocular lens implantation for the complications of proliferative diabetic retinopathy were analyzed retrospectively.Follw-up ranged from 8 to 64 months(median=25 months).Results: Retinal tears were the most frequent intraoperative problems(19%).Limited postoperative fibrin formation occurred in 22% of eyes.Within 6 months,7% developed glaucoma and 2% showed new anterior segment rudeosis.10% underwent secondary surgical Procedures ad followings: lavage for hemorrhage(n=3),silicone oil exchange after 7 days for focal rebleeding(n=1),silicone oil surgery for retinal detachment after gas resorption(n=1),and lavage for late vitreos hemorrhage(7 to 13months)Cn=4).Half of the secondary procedures were necessitated within 3 months of the original surgery.Conclusion:Combined surgery for retinal detachment after gas resorption(n=1),and lavage for late vitreos hemorrhage(7 to 13months)(n=4).Half of the secovdary procedures were necessitated within 3 months of the original surgery.Conclusion:Combined surgery in proliferative diabetic retinopathy is safe and effective.It should be considered when lens opacities are either present or likely to develop soon.更多还原