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糖尿病性黄斑水肿玻璃体切除术的对照研究。

A controlled study of vitrectomy for diabetic macular edema.

作者信息

Otani Tomohiro, Kishi Shoji

机构信息

Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Gunma, Japan.

出版信息

Am J Ophthalmol. 2002 Aug;134(2):214-9. doi: 10.1016/s0002-9394(02)01548-9.

Abstract

PURPOSE

To compare eyes that underwent surgery with untreated fellow eyes to assess the efficacy of vitrectomy for diabetic macular edema.

METHODS

In a nonrandomized clinical trial, seven adult patients with mean age of 53 years (range 42 to 64) and the same degree and duration of diabetic macular edema in both eyes were followed up for more than 5 months after unilateral vitrectomy. The treated eye was selected at random, but if visual disparity between the both eyes was more than 3 lines, we operated on the worse side. We compared the preoperative and postoperative foveal thicknesses (the distance between the inner retinal surface and retinal pigment epithelium) and the best-corrected visual acuity by a certified examiner with those of the untreated fellow eye.

RESULTS

In the seven eyes that underwent surgery, the foveal thickness decreased by an average of 622 to 269 microm (P =.027, Wilcoxon signed-rank test). In the fellow eyes, the average decrease in foveal thickness was from 617 to 546 microm (P =.176, Wilcoxon signed-rank test). The best-corrected postoperative visual acuity in the eyes that underwent surgery improved more than 2 lines in four eyes (57%) and remained the same in three eyes (43%). In the fellow eyes, it improved more than 2 lines in one eye (14%), remained the same in three eyes (43%), and decreased more than 2 lines in three eyes (43%).

CONCLUSION

In eyes with diabetic macular edema that underwent surgery, the foveal thickness significantly decreased after vitrectomy. Vitrectomy may be effective for treating diabetic macular edema.

摘要

目的

比较接受手术的眼睛与未治疗的对侧眼睛,以评估玻璃体切除术治疗糖尿病性黄斑水肿的疗效。

方法

在一项非随机临床试验中,7例平均年龄53岁(范围42至64岁)的成年患者,双眼糖尿病性黄斑水肿程度和病程相同,在单侧玻璃体切除术后随访超过5个月。治疗眼随机选择,但如果双眼视力差异超过3行,则对较差的一侧进行手术。我们由一名经过认证的检查人员将术前和术后的黄斑中心凹厚度(视网膜内表面与视网膜色素上皮之间的距离)及最佳矫正视力与未治疗的对侧眼睛进行比较。

结果

在接受手术的7只眼中,黄斑中心凹厚度平均从622微米降至269微米(P = 0.027,Wilcoxon符号秩检验)。在对侧眼中,黄斑中心凹厚度平均从617微米降至546微米(P = 0.176,Wilcoxon符号秩检验)。接受手术的眼睛术后最佳矫正视力在4只眼中提高超过2行(57%),在3只眼中保持不变(43%)。在对侧眼中,1只眼提高超过2行(14%),3只眼保持不变(43%),3只眼下降超过2行(43%)。

结论

在接受手术的糖尿病性黄斑水肿眼中,玻璃体切除术后黄斑中心凹厚度显著降低。玻璃体切除术可能对治疗糖尿病性黄斑水肿有效。

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