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目的分析晶状体超声乳化联合玻璃体手术治疗合并白内障的增生性糖尿病视网膜病变(PDR)的疗效。设计回顾性临床病例系列。研究对象123只合并不同程度白内障的PDR患眼。方法对123只合并不同程度白内障的PDR患眼实施晶状体超声乳化联合玻璃体手术治疗,同时I期植入人工晶状体(IOL),观察术后视力改善程度及术中术后并发症。主要指标术后视力改善程度、术后并发症发生率。结果123眼均实施晶状体超声乳化联合玻璃体手术,并同时一期植入IOL于囊袋内。随访时间3￣21月(平均10个月)。99眼(81%)术后均有不同程度的视力改善。其中93眼(76%)术后视力提高2行或以上。术后无明显角膜水肿和角膜内皮失代偿发生。1例I型糖尿病患者术后6个月发生新生血管性青光眼;1眼术后发生视网膜脱离,再次手术后复位;4眼因玻璃体腔出血再次手术。术后视力无明显改善或视力提高不足2行的病例均合并不同程度的糖尿病黄斑病变。结论晶状体超声乳化联合玻璃体手术是提高合并白内障的PDR患者视力的有效手段。糖尿病黄斑病变是影响术后视力提高的主要因素。(眼科,2006,15:198-201)
Objective To analyze the effect of phacoemulsification combined with vitrectomy in the treatment of proliferative diabetic retinopathy (PDR) with cataract. Design retrospective clinical case series. The study included 123 eyes with PDR with different degrees of cataract. Methods 123 eyes of PDR with cataract with different degrees were treated with phacoemulsification combined with vitrectomy. Intraocular lens (IOL) was implanted in stage I, and the postoperative visual acuity improvement and intraoperative and postoperative complications were observed. The main indicators Postoperative visual acuity improvement, postoperative complication rate. Results All 123 eyes underwent phacoemulsification combined with vitrectomy and IOL implantation in the capsular bag. Follow-up time 3 ~ 21 months (an average of 10 months). 99 eyes (81%) had different degrees of visual acuity after operation. Among 93 eyes (76%), visual acuity improved by 2 lines or more. No significant corneal edema and corneal endothelial decompensation occurred. One patient with type I diabetes developed neovascular glaucoma at 6 months after operation. One patient underwent retinal detachment after operation, and the other patient underwent reattachment after surgery. Four patients underwent reoperation due to vitreous hemorrhage. No significant improvement in visual acuity or visual acuity less than 2 lines of cases are associated with varying degrees of diabetic maculopathy. Conclusion Phacoemulsification combined with vitrectomy is an effective method to improve visual acuity in PDR patients with cataract. Diabetic maculopathy is the main factor that affects postoperative visual acuity. (Ophthalmology, 2006,15: 198-201)