玻璃体切割联合人工晶状体植入术治疗糖尿病视网膜病变合并白内障
|
摘要
目的:探讨玻璃体切割联合Ⅰ/Ⅱ期人工晶状体植入术治疗糖尿病视网膜病变合并白内障的临床疗效和安全性。方法:选取2015-03/2017-04于我院手术治疗糖尿病视网膜病变合并白内障的患者67例76眼,根据手术方式不同分为A组(Ⅰ期玻璃体切割+晶状体超声乳化摘除+硅油填充+人工晶状体植入术,Ⅱ期硅油取出术)和B组(Ⅰ期玻璃体切割+晶状体超声乳化摘除+硅油填充,Ⅱ期硅油取出+人工晶状体植入术)。比较两组患者视力改善、眼压及术后并发症情况。结果:术后3mo,两组患者视力改善情况无差异(P>0.05)。术前和术后3mo,两组患者眼压无明显变化(P>0.05)。两组患者玻璃体出血(3%vs 5%)、脉络膜出血(0%vs 2%)、视网膜脱落(6%vs 2%)、视网膜裂孔(6%vs 10%)发生率均无明显差异(P>0.05)。结论:玻璃体切割联合Ⅰ/Ⅱ期人工晶状体植入术治疗糖尿病视网膜病变合并白内障疗效无明显差异。
·AIM: To investigate the clinical efficacy and safety of vitrectomy combined with stage I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.·METHODS: Select 67 case(76 eyes) of diabetic retinopathy complicated with cataract patients in the First Affiliated Hospital of Jiamusi University during March 2015 to April 2017 as retrospective analysis. According to different surgical methods, they were divided into group A(stage I vitrectomy + phacoemulsification + silicone oil filling + intraocular lens implantation, phase II silicone oil extraction) and group B(stage I vitrectomy + lens phacoemulsification + silicone oil filling), stage II silicone oil extraction + intraocular lens implantation). The visual acuity improvement, intraocular pressure and postoperative complications were compared between the two groups.·RESULTS: At 3 mo after operation, there was no difference in visual acuity between the two groups(P>0.05). There was no significant change in intraocular pressure between the two groups 3 mo before and after surgery(P>0.05). Vitreous hemorrhage(3% vs 5%), choroidal hemorrhage(0% vs 2%), retinal detachment(6% vs 2%), retinal tears(6% vs 10%) There was no significant difference in incidence(P>0.05).·CONCLUSION: There was no significant difference in the efficacy of vitrectomy combined with I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.
·AIM: To investigate the clinical efficacy and safety of vitrectomy combined with stage I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.·METHODS: Select 67 case(76 eyes) of diabetic retinopathy complicated with cataract patients in the First Affiliated Hospital of Jiamusi University during March 2015 to April 2017 as retrospective analysis. According to different surgical methods, they were divided into group A(stage I vitrectomy + phacoemulsification + silicone oil filling + intraocular lens implantation, phase II silicone oil extraction) and group B(stage I vitrectomy + lens phacoemulsification + silicone oil filling), stage II silicone oil extraction + intraocular lens implantation). The visual acuity improvement, intraocular pressure and postoperative complications were compared between the two groups.·RESULTS: At 3 mo after operation, there was no difference in visual acuity between the two groups(P>0.05). There was no significant change in intraocular pressure between the two groups 3 mo before and after surgery(P>0.05). Vitreous hemorrhage(3% vs 5%), choroidal hemorrhage(0% vs 2%), retinal detachment(6% vs 2%), retinal tears(6% vs 10%) There was no significant difference in incidence(P>0.05).·CONCLUSION: There was no significant difference in the efficacy of vitrectomy combined with I/II intraocular lens implantation for diabetic retinopathy complicated with cataract.
引文
1张周斌, 薛振香, 汪慧等. 新疆喀什地区维吾尔族人群糖尿病患病情况及相关危险因素研究. 中华流行病学杂志2017;38(6):696-701
2张艾萍, 杨文. 2型糖尿病及合并并发症患者主要生化指标分析. 重庆医学 2017;46(21):2943-2944
3 Al-Rubeaan K, Abu El-Asrar AM, Youssef AM, et al. Diabetic retinopathy and its risk factors in a society with a type 2 diabetes epidemic:a Saudi National Diabetes Registry-based study. Acta Ophthalmol 2015;93(2):e140-147
4傅维娜, 陈梅珠, 王云鹏, 等. 手术前玻璃体腔注射雷珠单抗对增生型糖尿病视网膜病变患眼玻璃体切割手术操作时间及手术后视力的影响. 中华眼底病杂志 2016;32(1):26-30
5中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年). 中华眼科杂志 2014;50(11):851-865
6王光璐. 糖尿病视网膜病变的分级标准初探. 眼科 2005;14(4):218-220
7程琳, 李强, 王超, 等. ETDRS标准对数视力表视力测试. 中华实验眼科杂志 2011;29(6):574-575
8曹丹, 张良, 黄中宁, 等. 增生型糖尿病视网膜病变玻璃体切割手术后新生血管性青光眼的危险因素分析. 中华眼底病杂志 2015;31(2):147-149
9魏雁涛, 蒋欣桐, 张钊填, 等. 玻璃体腔注射雷珠单抗对增生型糖尿病视网膜病变患眼微创玻璃体切割手术及手术后视力的影响. 中华眼底病杂志 2015;31(4):337-340
10李军, 李思媛, 郑秀丽, 等. 玻璃体切割并晶状体切除硅油填充术治疗重度外源性眼内炎. 中国实用眼科杂志2015;33(3):279-282
11 Rasmussen ML, Broe R, Frydkjaer-Olsen U, et al. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy. J Diabetes Complications 2015;29(1):99-104
12佘海澄, 段安丽, 齐越, 等. 玻璃体切割联合重硅油眼内填充术治疗高度近视黄斑裂孔视网膜脱离的疗效评估. 中华实验眼科杂志 2015;33(2):171-174
13付浴东, 王萍, 江莉, 等. 玻璃体腔注射雷珠单抗、全视网膜激光光凝对增生型糖尿病视网膜病变患眼玻璃体切割手术及治疗效果的影响. 中华眼底病杂志 2015;31(2):143-146
14 Tandon A, Chen CJ, Penman A, et al. African Ancestry Analysis and Admixture Genetic Mapping for Proliferative Diabetic Retinopathy in African Americans. Invest Ophthalmol Vis Sci 2015;56(6):3999-4005
15谭娅, 周希瑗, 徐智勇, 等. 玻璃体切割术后眼超声乳化白内障摘出术中并发症的临床分析. 中华实验眼科杂志 2015;33(4):373-376
16 Schwartz S, Harasawa M, Baldivieso V, et al. Nonmydriatic fundus camera for diabetic retinopathy screening in a safety net hospital:effectiveness, prevalence, and risk factors. Eur J Ophthalmol 2015;25(2):145-152
2张艾萍, 杨文. 2型糖尿病及合并并发症患者主要生化指标分析. 重庆医学 2017;46(21):2943-2944
3 Al-Rubeaan K, Abu El-Asrar AM, Youssef AM, et al. Diabetic retinopathy and its risk factors in a society with a type 2 diabetes epidemic:a Saudi National Diabetes Registry-based study. Acta Ophthalmol 2015;93(2):e140-147
4傅维娜, 陈梅珠, 王云鹏, 等. 手术前玻璃体腔注射雷珠单抗对增生型糖尿病视网膜病变患眼玻璃体切割手术操作时间及手术后视力的影响. 中华眼底病杂志 2016;32(1):26-30
5中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年). 中华眼科杂志 2014;50(11):851-865
6王光璐. 糖尿病视网膜病变的分级标准初探. 眼科 2005;14(4):218-220
7程琳, 李强, 王超, 等. ETDRS标准对数视力表视力测试. 中华实验眼科杂志 2011;29(6):574-575
8曹丹, 张良, 黄中宁, 等. 增生型糖尿病视网膜病变玻璃体切割手术后新生血管性青光眼的危险因素分析. 中华眼底病杂志 2015;31(2):147-149
9魏雁涛, 蒋欣桐, 张钊填, 等. 玻璃体腔注射雷珠单抗对增生型糖尿病视网膜病变患眼微创玻璃体切割手术及手术后视力的影响. 中华眼底病杂志 2015;31(4):337-340
10李军, 李思媛, 郑秀丽, 等. 玻璃体切割并晶状体切除硅油填充术治疗重度外源性眼内炎. 中国实用眼科杂志2015;33(3):279-282
11 Rasmussen ML, Broe R, Frydkjaer-Olsen U, et al. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy. J Diabetes Complications 2015;29(1):99-104
12佘海澄, 段安丽, 齐越, 等. 玻璃体切割联合重硅油眼内填充术治疗高度近视黄斑裂孔视网膜脱离的疗效评估. 中华实验眼科杂志 2015;33(2):171-174
13付浴东, 王萍, 江莉, 等. 玻璃体腔注射雷珠单抗、全视网膜激光光凝对增生型糖尿病视网膜病变患眼玻璃体切割手术及治疗效果的影响. 中华眼底病杂志 2015;31(2):143-146
14 Tandon A, Chen CJ, Penman A, et al. African Ancestry Analysis and Admixture Genetic Mapping for Proliferative Diabetic Retinopathy in African Americans. Invest Ophthalmol Vis Sci 2015;56(6):3999-4005
15谭娅, 周希瑗, 徐智勇, 等. 玻璃体切割术后眼超声乳化白内障摘出术中并发症的临床分析. 中华实验眼科杂志 2015;33(4):373-376
16 Schwartz S, Harasawa M, Baldivieso V, et al. Nonmydriatic fundus camera for diabetic retinopathy screening in a safety net hospital:effectiveness, prevalence, and risk factors. Eur J Ophthalmol 2015;25(2):145-152