论文部分内容阅读
目的 探讨白内障合并增生性糖尿病视网膜病变 (proliferativediabeticretinopathy ,PDR)患者的玻璃体手术中 ,同期行白内障摘除和后房型人工晶状体 (intraocularlens,IOL)植入术的临床效果。方法 回顾性分析 1997年 2月至 2 0 0 1年 10月本院连续住院 ,并经同一手术医师治疗的增生性糖尿病视网膜病变患者 37例 (44只眼 )。其中男 12例 ,女 2 5例 ;13只右眼 ,17只左眼 ,7例双眼 ;年龄36～ 76岁 ,平均 5 7岁 ;患有糖尿病史 1～ 30年 ,眼病史 4 0d至 10年。手术中经平坦部做白内障摘除术 ,保留前囊并吸刮上皮层。在完成玻璃体手术和眼内激光光凝后 ,做角巩膜缘切口 ,将人工晶状体植入前囊上 ,然后环形切除前囊中央直径 5mm组织。术前患者视力为光感、眼前手动和指数者分别为 5、14和 11只眼 ,0 0 2者 6只眼 ,0 1～ 0 2者 8只眼。结果 术后随访 3个月至 4 5年 ,平均 (16±13)个月。患者视力改善 4 1只眼 ,不变 2只眼 ,下降 1只眼 ;其中 0 1～ 1 0者 35只眼 ,占 79 5 %。术后视力低下者多伴有明显的黄斑水肿、硬性渗出或视网膜广泛缺血。术后 2～ 5d ,有 6只眼发生轻度角膜水肿 ;术后 5个月 2只眼分别发生角膜溃疡和新生血管性青光眼。结论 在增生性糖尿病视网膜病变患者的玻璃体手术中 ,同期施行白
Objective To investigate the clinical effects of cataract extraction combined with intraocular lens implantation in vitreous surgery of patients with cataract and proliferative diabetic retinopathy (PDR). Methods A retrospective analysis was performed on 37 patients (44 eyes) with proliferative diabetic retinopathy who were hospitalized consecutively in our hospital from February 1997 to October 2001 and were treated by the same surgeon. There were 12 males and 25 females, 13 right eyes, 17 left eyes and 7 eyes. The age ranged from 36 to 76 years, with an average of 57 years. The patients had a history of diabetes of 1 to 30 years and a history of eye diseases from 40 days to 10 years year. During surgery, the cataract extraction was performed by the flat part, the anterior capsule was retained, and the epithelial layer was aspirated. After vitrectomy and intraocular laser photocoagulation, an angle scleral incision was made, the intraocular lens was implanted into the anterior capsule, and then the anterior capsule was circularly resected to a diameter of 5 mm. Preoperative visual acuity was light sensation in front of the manual and index were 5,14 and 11 eyes, 0 0 2 6 eyes, 0 1 ~ 0 2 8 eyes. Results The patients were followed up for 3 months to 45 years with an average of (16 ± 13) months. Patients with visual acuity improved 4 1 eye, unchanged 2 eyes, down 1 eye; of which 0 1 ~ 1 0 35 eyes, accounting for 79 5%. Postoperative visual acuity were mostly associated with macular edema, hard exudation or extensive retinal ischemia. In 2 ~ 5 days after operation, mild corneal edema occurred in 6 eyes; corneal ulcer and neovascular glaucoma occurred in 2 eyes 5 months after operation. Conclusions In vitreous surgery of patients with proliferative diabetic retinopathy, white is performed during the same period