联合手术治疗糖尿病视网膜病变合并白内障的临床观察被引量：5

Combined surgery for the treatment of cataract and proliferative diabetic retinopathy

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摘要目的:探讨玻璃体切除联合白内障超声乳化人工晶状体植入术在合并白内障的增生性玻璃体视网膜病变(proliferative diabetic retinopathy,PDR)中的临床治疗效果。方法:回顾性分析34例39眼合并白内障的PDR患者行睫状体平坦部玻璃体切除联合白内障超声乳化术,根据眼底情况是否植入人工晶状体的临床资料,观察术后视力恢复情况,视网膜病变情况以及手术并发症。结果:随访3mo^2a,视力<0.1者12眼,0.1~0.2者14眼,0.2~0.5者9眼,>0.5者4眼,与术前视力相比,差异有显著性。术后2~3mo眼底荧光造影检查,27眼眼底激光斑清晰,新生血管萎缩,无明显荧光渗漏,12眼有不同程度的微血管瘤以及荧光渗漏,16眼存在不同程度的黄斑水肿。手术并发症包括角膜水肿、医源性视网膜裂孔、高眼压、后囊膜混浊、玻璃体再出血。结论:玻璃体切除联合白内障超声乳化人工晶状体植入术是治疗合并白内障的增生性糖尿病视网膜病变安全有效的治疗手段。无严重并发症发生。 AIM：To investigate the clinical efficacy of the pars plana vitrectomy combined with phacoemulsification in the treatment of cataract and proliferative diabetic retinopathy（PDR）. METHODS： A retrospective review clinical data consisted of 39 eyes of 34 patients with cataract and PDR, 39 eyes were treated with the techniques of phacoemulsification and pars plana vitrectomy, intraocular lens was inserted in 32 eyes. Triamcinolone acetonide was injected in 11 eyes. RESULTS： Of 39 eyes after follow-up of 3 months to 2 years, vision 〈0.1 was in 12 eyes ,0.1- 0.2 in 14 eyes, 0.2- 0.5 in 9 eyes,〉0.5 in 4 eyes. Postoperatively FFA indicated that fluorescein leakage disappeared and new vascularization withered in 27 eyes, there were macular edema in 16 eyes. CONCLUSION： The pars plana vitrectomy combined with phacoemulsification is effective and safe in treatment of PDR and cataract, without serious complications.

作者李斌李琦李林

机构地区中国广东省广州市番禺区中心医院眼科

出处《国际眼科杂志》 CAS 2010年第4期748-749,共2页 International Eye Science

关键词增生性糖尿病视网膜病变白内障晶状体超声乳化玻璃体切除术 proliferative diabetic retinopathy cataract phacoemulsification vitrectomy

分类号 R779.6 [医药卫生—眼科] R587.1 [医药卫生—内分泌]

作者简介李斌，主任，副主任医师，副教授，研究方向：白内障、玻璃体视网膜疾病。通讯作者：李斌．ppy118208@sina．com

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1李明武,黎晓新,姜燕荣,鲍永珍.晶状体手术对增生型糖尿病视网膜病变患者玻璃体切割术后虹膜新生血管形成的影响[J].眼科研究,2000,18(1):60-62. 被引量：29
2惠延年,王琳,黄蔚,韩泉洪,王英.增生性糖尿病视网膜病变患者玻璃体手术中植入人工晶状体的临床效果观察[J].中华眼科杂志,2002,38(10):598-602. 被引量：27
3郭小健,朱晓华,唐罗生,陈百华.玻璃体切割联合超声乳化人工晶体植入术治疗增生性糖尿病视网膜病变[J].中国现代医学杂志,2005,15(16):2487-2489. 被引量：15

二级参考文献14

1郭小健,姜德咏,朱晓华,唐罗生.充气性视网膜固定术治疗单纯性孔源性视网膜脱离[J].中国现代医学杂志,2005,15(6):911-913. 被引量：9
2中华医学会眼科学会眼底病学组.糖尿病视网膜病变分期标准[J].眼底病,1985,1:42-42.
3原慧萍惠延年.全身疾病的眼部表现.眼科学（第5版）[M].北京:人民卫生出版社,2001.210-211.
4LAHEY JM, FRANCIS RR, KEARNEY JJ, et al. Combining phacoemulsification and vitrectomy in patients with proliferative diabetic retinopathy [J]. Curr Opin Ophthalmol, 2004, 15 (3):192-196.
5LAHEY JM, FRANCIS RR, KEARNEY JJ. Combining phacoemulsification with pars plana vitrectomy in patients with proliferative diabetic retinopathy: a series of 223 cases[J]. Ophthalmology.2003,110(7):1335-1339.
6KIM SH, CHUNG JW, CHUNG H, et al. Phacoemulsification and foldable intraocular lens implantation combined with vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy[J]. J Cataract Refract Surg, 2004, 30(8): 1721-1726.
7HONJO M, OGURA Y. Surgical results of pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation for complications of proliferative diabetic retinopathy[J]. Ophthalmic Surg Lasers, 1998, 29(2): 99-105.
8KADONOSONO K, MATSUMOTO S, UCHIO E, et al. Iris neovascularization after vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy[J]. Ophthalmic Surg Lasers, 2001, 32(1): 19-24.
9SHINODA K, O′HIRA A, ISHIDA S, et al. Posterior synechia of the iris after combined pars plana vitrectomy, phacoemulsification,and intraocular lens implantation[J]. Jpn J Ophthalmol, 2001, 45(3): 276-280.
10KIM SH, CHUNG JW, CHUNG H, et al. Phacoemulsification and foldable intraocular lens implantation combined with vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy[J]. Cataract Refract Surg, 2004, 30(8): 1721-1726.