Siam A L
Br J Ophthalmol. 1986 Feb;70(2):118-21. doi: 10.1136/bjo.70.2.118.
Sixty-six cases of advanced proliferative diabetic retinopathy were treated by external diathermy. The eyes had extensive fibrovascular proliferations growing into the vitreous. All had some blood, recent and old, in the vitreous. The vitreous was extremely degenerated and retracted. All the patients had inadequate diabetic control. More than half were hypertensive, with reasonable medical control, while a few had some degree of renal failure, with lower limb oedema. None of the cases were suitable for photocoagulation. Thirty-two control eyes were followed up together with the treated eyes for one to eight years. Of 53 eyes of patients with maturity onset diabetes 28 improved, 12 remained unchanged, and 13 deteriorated. Only two eyes developed neovascular glaucoma, while eight of 13 eyes of patients with juvenile diabetes improved. Of the control eyes, one regressed spontaneously, six remained unchanged, and 25 deteriorated. Of these 25 eyes eight developed traction detachment, 10 suffered relentless attacks of vitreous haemorrhage, and seven developed neovascular glaucoma. External diathermy appears to be a logical approach to cases which could not be treated by either photocoagulation or vitrectomy.
66例晚期增殖性糖尿病视网膜病变患者接受了巩膜外透热凝固术治疗。这些眼睛存在广泛的纤维血管增殖，长入玻璃体。所有患者的玻璃体中都有一些新鲜和陈旧的血液。玻璃体极度变性和后脱离。所有患者的糖尿病控制均不佳。超过半数患者患有高血压，经合理药物治疗，少数患者有一定程度的肾衰竭并伴有下肢水肿。所有病例均不适合进行光凝治疗。32只对照眼与治疗眼一起随访了1至8年。在53例成年发病型糖尿病患者的眼睛中，28只改善，12只无变化，13只恶化。仅2只眼发生新生血管性青光眼，而13例青少年糖尿病患者的眼睛中有8只改善。在对照眼中，1只自发消退，6只无变化，25只恶化。在这25只眼中，8只发生牵引性视网膜脱离，10只反复发生玻璃体出血，7只发生新生血管性青光眼。巩膜外透热凝固术似乎是一种对无法用光凝或玻璃体切除术治疗的病例的合理治疗方法。
