【摘要】 目的:观察糖尿病视网膜病变(diabetic retinopathy,DR)玻璃体切割术前视网膜光凝治疗的结果。方法:2004-08/2007-08,观察44例(66眼)伴有广泛视网膜水肿和黄斑水肿的增殖前期和增殖期DR患者,均在我院做过玻璃体切割术,根据术前1mo是否行过视网膜光凝将其分为A组(术前视网膜光凝组)36眼,B组(术前无视网膜光凝组)30眼。年龄45～70岁,治疗后随诊6～26(平均12.3)mo。比较两组患者术中并发症,术后视力改善情况。结果:A组:术中见视网膜水肿消退30眼,视网膜出血5眼,医源性裂孔2眼,视网膜切开2眼,硅油填充3眼。B组:术中见视网膜水肿消退0眼,视网膜出血15眼,医源性裂孔8眼,视网膜切开8眼,硅油填充9眼。两组术中情况比较差异有统计学意义(P<0.05)。两组患者手术前后视力均有改善,A组视力改善30眼,B组视力改善19眼,两组视力改善情况比较差异有统计学意义(P<0.05)。结论:选择在玻璃体切割手术前近期行视网膜光凝对合并广泛视网膜水肿的DR,手术预后明显好于无视网膜光凝组,建议在玻璃体切割手术前尽可能使用光凝治疗。更多还原

【Abstract】 AIM:To evaluate the significance of argon laser photocoagulation before vitrectomy in diabetic retinopathy.·METHODS:From August 2004 to August 2007,44 patien-ts(66eyes) of proliferative diabetic retinopathy(PDR) and NPDR with retinal edema,who underwent vitrectomy were analyzed. The patients were divided into two groups according to whether treated by argon laser photocoagu-lation before vitrectomy. Patients of group A(36eyes)were treated by laser photocoagulation before vitrectomy in one months,patients in group B(30eyes) were not treated by laser photocoagulation before vitrectomy. All the patients were followed up for 6-26 months after the operation.·RESULTS:During the operations,in group A,retinal edema disappeared in 30 eyes,retinal hemorrhage in 5 eyes,iatrogenic retinal hole in 2 eyes,intraocular silicone oil tamponade in 3 eyes. And patients in group B,retinal edema disappeared in 0 eyes,retinal hemorrhage in 15 eyes,iatrogenic retinal hole in 8 eyes,intraocular silicone oil tamponade in 9 eyes. The study showed significant differences between the patients in the two groups(P<0.05).·CONCLUSION:The laser photocoagulation before vitrectomy is useful for the treatment of diabetic retinopathy with retinal edema. It can reduce the com-plication and make the operation more successful and safe. It can also relieve the suffering and lighten the burden of the patients. Therefore,it is recommended to use the laser photocoagulation before performing vitrectomy in diabetic retinopathy.更多还原