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目的研究玻璃体腔注射抗新生血管生成药物联合23G玻璃体切除手术治疗严重增殖性糖尿病视网膜病变的临床疗效及并发症情况。方法采用回顾性非随机临床病例研究,共收集2014年5月—2016年5月严重增殖性糖尿病视网膜病变患者45例(45只眼)纳入研究,分析手术前后患者术眼的舒适度、局部水肿等主观自觉症状及最佳矫正视力、眼压、视网膜复位情况等客观指标,以及手术后并发症的发生情况。结果术后1周有30例(66.7%)患者的视力比术前提高,视力平均提高0.77±1.11。术后1个月有24例(88.9%)患者的视力比术前提高,视力平均提高1.29±0.97。术后发生再次玻璃体积血2例,发生孔源性视网膜脱离及高眼压各1例。结论玻璃体注射抗新生血管生成药物联合23G玻璃体切除手术安全、有效,能够改善多数严重增殖性糖尿病视网膜病变患者的视力预后。
Objective To study the clinical efficacy and complications of intravitreal injection of antiangiogenic drugs in combination with 23G vitrectomy for the treatment of severe proliferative diabetic retinopathy. Methods A retrospective, nonrandomized clinical case study was conducted. A total of 45 patients (45 eyes) with severe proliferative diabetic retinopathy from May 2014 to May 2016 were enrolled in the study. The surgical eye comfort, local edema And other subjective symptoms and best corrected visual acuity, intraocular pressure, retinal reattachment and other objective indicators, as well as the incidence of postoperative complications. Results One week after operation, 30 cases (66.7%) had higher visual acuity than that before operation, and the average visual acuity increased by 0.77 ± 1.11. 24 months (88.9%) patients had a higher visual acuity than preoperative one month after surgery, and the average visual acuity increased by 1.29 ± 0.97. There were 2 cases of vitreous hemorrhage again after operation, and 1 case had rhegmatogenous retinal detachment and high intraocular pressure. Conclusions Intravitreal injection of antiangiogenic drugs in combination with 23G vitrectomy is safe and effective, which can improve the vision prognosis of most patients with severe proliferative diabetic retinopathy.