论文部分内容阅读
目的探讨术前玻璃体腔注射雷珠单抗对增生型糖尿病视网膜病变(PDR)患眼玻璃体切割手术后视力的影响。方法选取2012年7月至2015年7月于抚顺市眼病医院住院治疗并具有完整临床资料的PDR患者50例58只患眼为研究对象,按照治疗方法不同分为对照组和观察组,其中对照组24例27只眼采用单纯玻璃体切割手术治疗,观察组26例31只眼在进行玻璃体切割手术前先行雷珠单抗处理。比较两组患者手术中的一般情况、术后视力变化及并发症发生情况。结果观察组患者手术过程中电凝、硅油填充、惰性气体填充及医源性裂孔的发生率均低于对照组,差异均有统计学意义(均P<0.05);观察组患者术后平均Log MAR BCVA改善情况及视力提高率均显著高于对照组,差异均有统计学意义(均P<0.05);两组患者均出现前房渗出、积血、高眼压、玻璃体再积血等并发症,但观察组患者的并发症发生率为35.5%,显著低于对照组的74.1%,差异有统计学意义(P<0.05)。结论术前玻璃体腔注射雷珠单抗对PDR的效果更好,可显著改善患者的视力,减少术中电凝的使用,降低医源性裂孔及术后并发症的发生率,安全性好,在患者能够接受的情况下,可考虑作为PDR术前的常规治疗。
Objective To investigate the effect of preoperative intravitreal injection of ranibizumab on the visual acuity of patients with proliferative diabetic retinopathy (PDR) after vitrectomy. Methods Fifty-five eyes of 50 PDR patients hospitalized in Fushun Eye Hospital from July 2012 to July 2015 in our hospital were selected and divided into control group and observation group according to the different treatment methods A total of 24 eyes (27 eyes) were treated by simple vitrectomy. In the observation group, 26 eyes (31 eyes) were treated with ranibizumab before vitrectomy. The general situation of surgery, visual acuity and complications of the two groups were compared. Results The incidences of electrocoagulation, silicone oil filling, inert gas filling and iatrogenic hiatus in the observation group were significantly lower than those in the control group (all P <0.05). The average postoperative Log MAR BCVA improvement and vision improvement rate were significantly higher than the control group, the difference was statistically significant (both P <0.05); both groups of patients with anterior chamber exudate, hemorrhage, intraocular hypertension, vitreous hemorrhage However, the incidence of complication in the observation group was 35.5%, which was significantly lower than that in the control group (74.1%), the difference was statistically significant (P <0.05). Conclusion Preoperative intravitreal injection of ranibizumab is more effective on PDR, which can significantly improve the patient’s vision, reduce the use of intraoperative coagulation, reduce the incidence of iatrogenic hiatus and postoperative complications, good safety, In patients with acceptable circumstances, can be considered as PDR preoperative routine treatment.