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增殖性糖尿病视网膜病变行玻璃体切割术时,玻璃体后脱离后玻璃体内注射曲安奈德的长期疗效。

Long-term outcomes of administration of intravitreal triamcinolone acetonide after posterior vitreous detachment during pars plana vitrectomy for proliferative diabetic retinopathy.

作者信息

Liao Mengyu, Huang Yunli, Wang Jiaxing, Meng Xiangda, Liu Yuanyuan, Yu Jinguo, Yan Hua

机构信息

Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.

出版信息

Br J Ophthalmol. 2023 Apr;107(4):560-564. doi: 10.1136/bjophthalmol-2021-320332. Epub 2021 Nov 29.

Abstract

AIM

To evaluate the long-term outcomes of intravitreal triamcinolone acetonide (TA) administration after posterior vitreous detachment (PVD) during pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR).

METHODS

A total of 189 eyes (152 patients) who underwent PPV for severe PDR were reviewed. Intravitreal injection of TA (IVTA) was administered during PPV in 118 eyes (PPV+IVTA group), and 71 eyes did not receive IVTA (PPV group). Immediately after PVD, when most of the vitreous and proliferative membranes were removed, 0.1 mL TA (40 mg/mL) was injected into the vitreous cavity in the PPV+IVTA group. All patients were followed-up for least 12 months. Visual outcomes and postoperative complications were recorded and compared between the two groups.

RESULTS

IVTA was helpful for proliferative membrane peeling and haemostasis during PPV. In the PPV+IVTA group, best-corrected visual acuity had significantly improved and the intraocular pressure was controlled well during the follow-up. The incidence of early recurrent vitreous haemorrhage after PPV was significantly lower in the PPV+IVTA group (1.7%) than in the PPV group (9.9%) (p=0.028).

CONCLUSION

The administration of IVTA after PVD during PPV can effectively improve the final visual outcomes and prevent postoperative complications in patients with severe PDR.

摘要

目的

评估增殖性糖尿病视网膜病变(PDR)患者在玻璃体切割术(PPV)中玻璃体后脱离(PVD)后玻璃体内注射曲安奈德(TA)的长期疗效。

方法

回顾性分析152例接受PPV治疗严重PDR的189只眼。118只眼在PPV术中接受了玻璃体内注射TA(IVTA)(PPV + IVTA组),71只眼未接受IVTA(PPV组)。在PVD后,当大部分玻璃体和增殖膜被切除后,PPV + IVTA组向玻璃体腔注射0.1 mL TA(40 mg/mL)。所有患者至少随访12个月。记录并比较两组的视力结果和术后并发症。

结果

IVTA有助于PPV术中增殖膜的剥离和止血。在PPV + IVTA组,随访期间最佳矫正视力显著提高,眼压控制良好。PPV + IVTA组PPV术后早期复发性玻璃体出血的发生率(1.7%)显著低于PPV组(9.9%)(p = 0.028)。

结论

PPV术中PVD后给予IVTA可有效改善严重PDR患者的最终视力结果并预防术后并发症。

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