【摘要】 目的探讨经睫状体平坦部闭合式玻璃体切除联合保留前囊晶状体超声乳化及后房型人工晶状体(PCIOL)植入(联合手术)治疗合并白内障的增生性糖尿病视网膜病变(PDR)的临床效果。方法回顾性分析合并不同程度白内障的PDR36例(39眼)实施联合手术,观察术后视力改善程度及术中、术后并发症。结果36例(39眼)成功地进行了联合手术。术后随访2月～3年半,平均13.4月。术后37眼(94.87%)视力不同程度提高,视力≥0.05者26眼(66.67%),≥0.1者17眼(43.59%),≥0.3者7眼(17.95%);视力下降2眼(5.13%)。术后视力低下者伴有糖尿病性黄斑水肿、硬性渗出或糖尿病性视神经病变。术中并发症包括晶状体核碎块致视网膜损伤3眼(7.69%)及前囊破裂2眼(5.13%);术后并发症包括玻璃体积血4眼(10.26%),角膜轻度水肿和一过性眼压升高各2眼(5.13%),后发障3眼(7.69%),虹膜红变和眼球萎缩各1眼(2.56%)。结论经睫状体平坦部闭合式玻璃体切除联合保留前囊晶状体超声乳化及PCIOL植入术较安全有效。更多还原

【Abstract】 Objective To evaluate the clinical outcomes of pars plana vitrectomy combined with phacoemulsification retaining anterior capsule and posterior chamber intraocular lens(PCIOL) implantation in treatment of patients with concomitant cataract and proliferative diabetic retinopathy(PDR).Methods This retrospective study consisted of 39 eyes of 36 patients with PDR and clinically significant lens opacities.Pars plana vitrectomy was combined with phacoemulsification retaining anterior capsule and PCIOL implantation.Postoperative visual acuity and intra-and post-operative complications were analyzed.Results 36 cases(39 eyes) underwent combined surgery successfully.The median follow up was(13.4±8.6)months(range 2～42 months).The postoperative visual acuity improved in 37 eyes(94.6%),of them,being≥0.05 in 26 eyes(66.7%),≥0.1 in 17 eyes(43.6%),≥0.3 in 7 eyes(17.95);while visual acuity after operation decreased in 2 eyes(5.1%).Diabetic macular abnormalities or optic neuropathy presented to eyes with low visual acuity.Intra-operative complications included retinal injury caused by the piece of the lens nucleus in 3 eyes(7.7%) and anterior capsule tears in 2 eyes(5.1%);post-operative complications included vitreous hemorrhage in 4 eyes(10.3%),corneal edema and transient intraocular pressure rise in 2 eyes(5.1%) respectively,secondary cataract in 3 eves(7.7%),rubeosis iridis and eyeball atrophy in one eye(2.6%) respectively.Conclusions Combined surgery is safe and effective,and so can be widely used.更多还原