Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361100 Fujian, China.
Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, 361002 Fujian, China.
Comput Math Methods Med. 2022 Aug 4;2022:7393661. doi: 10.1155/2022/7393661. eCollection 2022.
To evaluate the clinical efficacy of the combined application of 23G minimally invasive vitrectomy, glaucoma drainage valve implantation, and phacoemulsification cataract extraction in the treatment of neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR) combined with vitreous hemorrhage (VH).
Eighty-three patients (91 eyes) with PDR diagnosed as NVG phase III complicated with VH from June 2018 to May 2020 were selected as the study subjects. The subjects were randomly divided into 3 groups: group A was treated with 23G minimally invasive vitrectomy combined with glaucoma drainage valve implantation; group B was given 23G minimally invasive vitrectomy combined with phacoemulsification cataract extraction; and group C was treated with 23G minimally invasive vitrectomy combined with glaucoma drainage valve implantation and phacoemulsification cataract extraction. The uncorrected visual acuity (UCVA), intraocular pressure (IOP), and iris neovascularization (INV) scores were recorded and compared among the 3 groups before and after operation, and then the postoperative pain relief and complications were observed.
Through observation, there was no significant difference in the UCVA, IOP, and INV scores in the 3 groups before operation. After the operation, the UCVA, IOP, and INV scores of the 3 groups were significantly lower than those before operation. After operation, the UCVA of the 3 groups increased first and then decreased, and it improved most significantly in the 3rd month after operation and decreased in the 4th month after operation. There were significant differences in UCVA among the 3 groups at each time point after operation. From the 1st day to the 6th month after operation, the IOP of the 3 groups showed an upward trend, and there was no significant difference among the 3 groups in IOP at each time point after operation. At the 1st, 3rd, and 6th months after operation, the INV score of group A and group B was higher than that of group C. There was no significant difference in the INV score between group A and group B. The incidence of complications was not significantly different among the 3 groups.
23G minimally invasive vitrectomy, glaucoma drainage valve implantation, and phacoemulsification cataract extraction can effectively improve the UCVA, IOP, and INV scores of NVG secondary to PDR with VH, and the combined application of the 3 methods has better security.
评估 23G 微创玻璃体切除术联合青光眼引流阀植入术与超声乳化白内障吸除术治疗增生性糖尿病视网膜病变（PDR）合并玻璃体积血（VH）继发新生血管性青光眼（NVG）的临床疗效。
选取 2018 年 6 月至 2020 年 5 月期间被诊断为 PDR 期并发 VH 的 NVG 患者 83 例（91 只眼）为研究对象，采用随机数字表法将其分为 3 组：A 组采用 23G 微创玻璃体切除术联合青光眼引流阀植入术治疗；B 组采用 23G 微创玻璃体切除术联合超声乳化白内障吸除术治疗；C 组采用 23G 微创玻璃体切除术联合青光眼引流阀植入术与超声乳化白内障吸除术治疗。记录并比较 3 组患者术前及术后的视力（UCVA）、眼压（IOP）、虹膜新生血管（INV）评分，观察术后疼痛缓解及并发症发生情况。
经观察，3 组患者术前的 UCVA、IOP、INV 评分比较，差异均无统计学意义（P＞0.05）。术后，3 组患者的 UCVA、IOP、INV 评分均低于术前，术后 3 个月时 3 组患者的 UCVA 升高最为显著，术后 4 个月时 UCVA 降低，术后各时间点 UCVA 组间比较，差异均有统计学意义（P＜0.05）。术后 1～6 个月，3 组患者的 IOP 呈上升趋势，术后各时间点 IOP 组间比较，差异均无统计学意义（P＞0.05）。术后 1、3、6 个月时，A 组和 B 组的 INV 评分均高于 C 组，A 组和 B 组的 INV 评分比较，差异无统计学意义（P＞0.05）。3 组患者的并发症发生率比较，差异无统计学意义（P＞0.05）。
23G 微创玻璃体切除术联合青光眼引流阀植入术与超声乳化白内障吸除术可有效改善 PDR 合并 VH 继发 NVG 患者的 UCVA、IOP、INV 评分，且 3 种方法联合应用安全性更好。
