玻璃体腔注射雷珠单抗联合玻璃体切除术治疗PDR的疗效
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摘要
目的:观察玻璃体腔注射雷珠单抗联合玻璃体切除术治疗增殖性糖尿病视网膜病变(PDR)的临床疗效。方法:回顾性研究。选取2016-05/2017-05于我院眼科治疗的PDR患者60例66眼,根据治疗方式不同分为两组,均为30例33眼。A组患者玻璃体切除术前3～5d注射雷珠单抗,B组患者仅行玻璃体切除术。比较两组患者术中医源性视网膜裂孔、玻璃体内出血及术后视力和并发症发生情况。结果:术中两组患者均出现医源性视网膜裂孔、玻璃体内出血,A组医源性视网膜裂孔眼数、术中玻璃体内出血发生率均低于B组(P<0.05)。术后A组患者视力改善优于B组(P<0.05)。手术治疗后,A组患者玻璃体内出血、高眼压和黄斑水肿眼数较B组少(P<0.05)。结论:术前接受玻璃体腔注射雷珠单抗联合玻璃体切除术治疗PDR能有效减少医源性视网膜裂孔、术中玻璃体内出血的情况发生,术后并发症较少,有利于患者恢复。
?AIM: To observe the clinical effect of intravitreal injection of ranibizumab combined with vitrectomy in the treatment of proliferative diabetic retinopathy(PDR).?METHODS: A retrospective study. Sixty patients(66 eyes) with PDR who underwent vitrectomy in our hospital from May 2016 to May 2017 were divided into two groups according to different treatment methods, 30 cases(33 eyes). ranibizumab were injected into vitreous cavity 3-5 d before operation in group A, but not in group B. The incidence of iatrogenic retinal holes, intravitreal hemorrhage, visual acuity and complications were compared between the two groups.?RESULTS:Iatrogenic retinal hiatus and intravitreal hemorrhage occurred in both groups during operation. The number of eyes with iatrogenic retinal hiatus and the incidence of intravitreal hemorrhage in group A were less than those in group B(P<0.05). The visual acuity of group A was better than that of group B(P<0.05). After operation, the number of eyes with intravitreal hemorrhage, high intraocular pressure and macular edema in group A was less than that in group B(P<0.05).?CONCLUSION: Preoperative intravitreal injection of ranibizumab combined with vitrectomy for PDR can effectively reduce iatrogenic retinal hiatus and intravitreal hemorrhage. Postoperative complications are less, which is conducive to the recovery of patients.
?AIM: To observe the clinical effect of intravitreal injection of ranibizumab combined with vitrectomy in the treatment of proliferative diabetic retinopathy(PDR).?METHODS: A retrospective study. Sixty patients(66 eyes) with PDR who underwent vitrectomy in our hospital from May 2016 to May 2017 were divided into two groups according to different treatment methods, 30 cases(33 eyes). ranibizumab were injected into vitreous cavity 3-5 d before operation in group A, but not in group B. The incidence of iatrogenic retinal holes, intravitreal hemorrhage, visual acuity and complications were compared between the two groups.?RESULTS:Iatrogenic retinal hiatus and intravitreal hemorrhage occurred in both groups during operation. The number of eyes with iatrogenic retinal hiatus and the incidence of intravitreal hemorrhage in group A were less than those in group B(P<0.05). The visual acuity of group A was better than that of group B(P<0.05). After operation, the number of eyes with intravitreal hemorrhage, high intraocular pressure and macular edema in group A was less than that in group B(P<0.05).?CONCLUSION: Preoperative intravitreal injection of ranibizumab combined with vitrectomy for PDR can effectively reduce iatrogenic retinal hiatus and intravitreal hemorrhage. Postoperative complications are less, which is conducive to the recovery of patients.
引文
1 Sommerville DN.Vitrectomy for vitreous floaters:analysis of the benefits and risks.Curr Opin Ophthalmol 2015;26(3):173-176
2 Madgula IM,Anand N.Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma.Indian J Ophthalmol 2014;62(12):1115-1120
3 Min ETL,Goh Y,Wan-Hazabbah WH,et al.Factors predicting visual improvement post pars plana vitrectomy for proliferative diabetic retinopathy.GuoJi Yanke Zazhi(Int Eye Sci) 2017;17(8):1404-1409
4苏丹,李虹霓,李洪龙.玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效观察.中国现代医生 2013;51(22):14-15
5陈乔,聂尚武,王晓琴.玻璃体切除术联合不同晶状体摘除术在增殖型糖尿病视网膜病变中的疗效比较.实用医学杂志 2016;32(8):1311-1314
6尹妮,赵帅,朱红娜.康柏西普和雷珠单抗联合玻璃体切除术治疗PDR的疗效比较.国际眼科杂志 2017;17(7):1300-1302
7张招德.康柏西普辅助玻璃体手术治疗增殖性糖尿病性视网膜病变的临床疗效.中外医疗2016;35(36):73-75
8 Morales-Canton V,Kawakami-Campos PA.Machines and cutters:VersaVIT-potential and perspectives of office-based vitrectomy.Dev Ophthalmol 2014;54:17-22
9王颖,阿子古力·沙木沙克,于继,等.玻璃体切割联合白内障手术治疗增殖性糖尿病视网膜病变中的疗效.现代生物医学进展 2017;17(25):4959-4962
10张慧敏.玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效分析.糖尿病新世界 2014;17(14):34-36
11 DeMarchis EH,Pershing S,Moshfeghi DM.Clinical-pathologic correlation:vitrectomy with epiretinal and internal limiting membrane peel.Ophthalmic Surg Lasers Imaging Retina 2014;45(3):218-221
12 Jayaram H,Becker S,Eastlake K,et al.Optimized feline vitrectomy technique for therapeutic stem cell delivery to the inner retina.Vet Ophthalmol 2014;17(4):300-304
13 Nitta E.Displacement of the retina and its recovery after vitrectomy in idiopathic epiretinal membrane.Am J Ophthalmol 2013;155(6):1014-1020
14 Rizzo S,Belting C,Genovesi-Ebert F,et al.Author's reply to:Optic disc pit maculopathy:the value of small-gauge vitrectomy,peeling,laser treatment,and gas tamponade.Eur J Ophthalmol 2013;23(2):276
15沙亚飞,龙心光,王训刚.23G微创全玻璃体切除术治疗增殖期糖尿病视网膜病变的疗效分析.临床医学 2015;35(12):109-110
16胡新苗.视网膜光凝联合玻璃体切除术治疗增生性糖尿病视网膜病变的有效性及安全性.山东大学耳鼻喉眼学报 2015;29(6):74-77
17余萍.术前玻璃体腔内注射抗VEGF对增殖性糖尿病性视网膜病变行玻璃体术的影响研究.高原医学杂志 2015;25(4):21-24
18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
2 Madgula IM,Anand N.Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma.Indian J Ophthalmol 2014;62(12):1115-1120
3 Min ETL,Goh Y,Wan-Hazabbah WH,et al.Factors predicting visual improvement post pars plana vitrectomy for proliferative diabetic retinopathy.GuoJi Yanke Zazhi(Int Eye Sci) 2017;17(8):1404-1409
4苏丹,李虹霓,李洪龙.玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效观察.中国现代医生 2013;51(22):14-15
5陈乔,聂尚武,王晓琴.玻璃体切除术联合不同晶状体摘除术在增殖型糖尿病视网膜病变中的疗效比较.实用医学杂志 2016;32(8):1311-1314
6尹妮,赵帅,朱红娜.康柏西普和雷珠单抗联合玻璃体切除术治疗PDR的疗效比较.国际眼科杂志 2017;17(7):1300-1302
7张招德.康柏西普辅助玻璃体手术治疗增殖性糖尿病性视网膜病变的临床疗效.中外医疗2016;35(36):73-75
8 Morales-Canton V,Kawakami-Campos PA.Machines and cutters:VersaVIT-potential and perspectives of office-based vitrectomy.Dev Ophthalmol 2014;54:17-22
9王颖,阿子古力·沙木沙克,于继,等.玻璃体切割联合白内障手术治疗增殖性糖尿病视网膜病变中的疗效.现代生物医学进展 2017;17(25):4959-4962
10张慧敏.玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效分析.糖尿病新世界 2014;17(14):34-36
11 DeMarchis EH,Pershing S,Moshfeghi DM.Clinical-pathologic correlation:vitrectomy with epiretinal and internal limiting membrane peel.Ophthalmic Surg Lasers Imaging Retina 2014;45(3):218-221
12 Jayaram H,Becker S,Eastlake K,et al.Optimized feline vitrectomy technique for therapeutic stem cell delivery to the inner retina.Vet Ophthalmol 2014;17(4):300-304
13 Nitta E.Displacement of the retina and its recovery after vitrectomy in idiopathic epiretinal membrane.Am J Ophthalmol 2013;155(6):1014-1020
14 Rizzo S,Belting C,Genovesi-Ebert F,et al.Author's reply to:Optic disc pit maculopathy:the value of small-gauge vitrectomy,peeling,laser treatment,and gas tamponade.Eur J Ophthalmol 2013;23(2):276
15沙亚飞,龙心光,王训刚.23G微创全玻璃体切除术治疗增殖期糖尿病视网膜病变的疗效分析.临床医学 2015;35(12):109-110
16胡新苗.视网膜光凝联合玻璃体切除术治疗增生性糖尿病视网膜病变的有效性及安全性.山东大学耳鼻喉眼学报 2015;29(6):74-77
17余萍.术前玻璃体腔内注射抗VEGF对增殖性糖尿病性视网膜病变行玻璃体术的影响研究.高原医学杂志 2015;25(4):21-24
18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