Pavan P R, Weingeist T A, McLane N J
Int Ophthalmol Clin. 1984 Winter;24(4):47-60.
Diabetic vitrectomy is usually performed to remove vitreous blood or to relieve traction of the macula. In addition to removing vitreous opacities and severing all anteroposterior connections of the posterior hyaloid face with a cutting and sucking probe, tangential traction in and around the macula is eliminated by sectioning preretinal membranes with intraocular scissors. Complications are significant in terms of both their incidence and their consequences. They include choroidal or subretinal infusion, peripheral and posterior retinal breaks, intraoperative bleeding, and neovascular glaucoma. Proper management can minimize the occurrence and adverse effects of these complications. If prognostic factors are favorable, visual improvement occurs in 78 to 59% of eyes postoperatively. Preoperative iris neovascularization, florid proliferative diabetic retinopathy, long-standing detachment of the macula, and iatrogenic retinal breaks are all correlated with significantly lower success rates. Three independent studies have shown that if visual improvement is present 6 months postoperatively, the results are usually long-standing [2, 8, 20].
糖尿病性玻璃体切除术通常用于清除玻璃体积血或缓解黄斑部的牵引。除了用切割吸引探头清除玻璃体混浊并切断后玻璃体膜的所有前后连接外，还需用眼科剪刀切开视网膜前膜，以消除黄斑部及其周围的切线牵引。并发症在发生率及其后果方面都很严重。它们包括脉络膜或视网膜下灌注、周边和后部视网膜裂孔、术中出血以及新生血管性青光眼。恰当的处理可将这些并发症的发生及其不良影响降至最低。如果预后因素良好，术后78%至59%的患眼视力会有所改善。术前虹膜新生血管形成、严重的增殖性糖尿病视网膜病变、长期的黄斑脱离以及医源性视网膜裂孔均与显著较低的成功率相关。三项独立研究表明，如果术后6个月视力有所改善，结果通常是持久的[2, 8, 20]。
