Hui Y, Wang L, Wang Y, Huang W, Han Q
Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Yan Ke Xue Bao. 2001 Dec;17(4):241-4.
To evaluate the efficacy of vitreous surgery and photocoagulation for treatment of a series of patients with proliferative diabetic retinopathy(PDR).
A consecutive series of PDR treated with vitrectomy and photocoagulation during February 1997 to May 2000 was retrospectively analyzed.
The series included 79 cases (38 male and 41 female) and 104 eyes [oculus dexter(OD), 26; oculus sinister(OS), 28; oculus uterque(OU), 25] with diabetic history for 0.5-37 (8.5 +/- 6.5) years and eye symptoms for 15 days to 1.5 years (1.5 +/- 1.5 years). Retinal photocoagulation was performed in 30 eyes with only once in 26 eyes before vitrectomy. Surgical techniques included standard vitrectomy, neovascular membrane peeling and fragmentation, endo--diathermy and endolaser. Silicone oil was injected in 59 eyes with active bleeding, retinal detachment, or severe ischemia. Cataract extraction was done in 63 eyes, of which 27 eyes with intraocular lens implantation. Visual acuity was light perception(LP), hand movement(HM), count fingers(CF), and > or = 0.02 in 15, 38, 22, and 29 eyes, respectively before operation. Visual improvement achieved in 84 eyes (80.8%) with > or = 0.1 in 41 eyes (39.4%). Visual acuity remained unchanged or decreased in 20 eyes (20.2%). Neovascular glaucoma occurred in two eyes after surgery.
Although the series of patients with PDR without sufficient retinal photocoagulation before operation, vitrectomy and endolaser improved the visual outcome in the majority of eyes. Silicone oil injected in eyes with severe ischemia, active bleeding or retinal detachment may provide chance for prompt laser coagulation after surgery in order to prevent progression of PDR.
评估玻璃体手术和光凝治疗一系列增生性糖尿病视网膜病变（PDR）患者的疗效。
回顾性分析1997年2月至2000年5月期间连续接受玻璃体切除术和光凝治疗的PDR患者系列。
该系列包括79例患者（男性38例，女性41例）和104只眼[右眼（OD）26只；左眼（OS）28只；双眼（OU）25只]，糖尿病病史0.5 - 37（8.5±6.5）年，眼部症状持续15天至1.5年（1.5±1.5年）。30只眼进行了视网膜光凝，其中26只眼在玻璃体切除术前仅进行了一次。手术技术包括标准玻璃体切除术、新生血管膜剥离和碎片化、眼内透热疗法和眼内激光光凝。59只眼因活动性出血、视网膜脱离或严重缺血而注入了硅油。63只眼进行了白内障摘除术，其中27只眼植入了人工晶状体。术前视力分别为光感（LP）、手动（HM）、数指（CF）和≥0.02的眼数分别为15只、38只、22只和29只。84只眼（80.8%）视力得到改善，其中41只眼（39.4%）视力≥0.1。20只眼（20.2%）视力保持不变或下降。术后有2只眼发生新生血管性青光眼。
尽管该系列PDR患者术前未进行充分的视网膜光凝，但玻璃体切除术和眼内激光光凝改善了大多数患眼的视力预后。对严重缺血、活动性出血或视网膜脱离的患眼注入硅油可为术后及时进行激光光凝提供机会，以防止PDR进展。
