【摘要】 目的观察术前应用康柏西普眼内注射对23G玻切治疗增殖性糖尿病视网膜病变疗效的影响。方法回顾性病例对照研究。观察增殖性糖尿病视网膜病变手术患者共46人50只眼,药物注射辅助组22例,术前3~7天给予玻璃体腔注射10 mg/ml的康柏西普0.5 mg(0.05 ml);单纯手术对照组28例,常规行23G玻璃体切割术。对比两组术后最佳矫正视力log MAR BCVA、手术时间、医源性裂孔发生率、电凝使用次数、术中及术后出血发生率情况。结果随访两组术后12 m平均log MAR BCVA分别为(0.75±0.22)和(1.14±0.50)(P<0.05);注药组平均手术时间为(74.27±16.82)min,而对照组为(98.56±13.74)min(P<0.05);医源性裂孔在注药组中有2例,占9.09%,而对照组中有6例,占21.43%(P<0.05);在注药组术中有4例使用电凝,占18.18%,对照组为16例,占57.14%(P<0.05);注药组有1例出现术中出血,占4.55%,对照组为11例,占39.29%(P<0.05);注药组有1例出现术后复发玻璃体积血,占4.55%,对照组为5例,占17.86%(P<0.05)。结论在应用23G微创玻切治疗增殖性糖尿病视网膜病变术前玻璃体腔注射康柏西普可以显著提高术后视力,缩短手术时间,减少医源性裂孔和术中术后出血的发生率,降低手术难度及减少并发症的发生。更多还原

【Abstract】 Objective To observe the effect of preoperative intravitreal conbercept injection before 23 G pars plana vitrectomy( PPV) for proliferative diabetic retinopathy. Methods To retrospect and study the cases.46 patients 50 eyes with severe proliferative diabetic retinopathy who were divided into drug group( 23 G pars plana vitrectomy assisted by preoperative intravitreal conbercept injection 3 ~ 7 days before operation,22 eyes)and control group( 23 G pars plana vitrectomy,28 eyes). Main outcomes measures were log MAR BCVA,operation time,incidence of iatrogenic retinal breaks,endodiathermy times,the number of bleeding in operation and postoperative. Results At 12 months after surgery,the average log MAR BCVA of the drug group and control group was respectively( 0. 75 ± 0. 22) and( 1. 14 ± 0. 50),the visual acuity of both group improved significantly( P < 0. 05). The average operation time was 74. 27 ± 16. 82 minutes and 98. 56 ± 13. 74 minutes in drug group and control group respectively( P < 0. 05). Iatrogenic retinal breaks were reported in 2 cases( 9. 09%) in drug group and 6 cases( 21. 43%) in control group( P < 0. 05). Endodiathermy was employed in 4 cases( 18. 18%)in drug group and 16 cases( 57. 14%) in control group( P < 0. 05). The number of bleeding in operation was reported in 1 case( 4. 55%) in drug group while 11 cases( 39. 29%) were reported in control group( P <0. 05). Postoperative bleeding was reported in 1 case( 4. 55%) in drug group while 5 cases( 17. 86%) were reported in control group( P < 0. 05). Conclusions Intravitreal injection of Conbercept for proliferative diabetic retinopathy before 23-gauge micro-invasive vitrectomy had a significant effect. It can obviously improve visual acuity,reduce operation time,the incidence of iatrogenic retinal break,the employment of endodiathermy,the number of bleeding in operation and postoperative,and reduce the difficulty and the incidence of surgical complications.更多还原