van Effenterre G, Guyot-Argenton C, Guiberteau B, Hany I, Lacotte J L
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingst, Paris.
J Fr Ophtalmol. 1993;16(11):602-10.
We have observed some patients with diabetic macular edema who did not respond to grid laser treatment and who improved with spontaneous posterior vitreous detachment or vitrectomy. These cases have a taut and glistening vitreo-macular interface. Three such cases are presented in detail. Pars plana vitrectomy with separation of the posterior hyaloid was performed in 22 cases. All of them had proliferative diabetic retinopathy, previously treated by panretinal photocoagulation. Fourteen cases had an ineffective macular grid laser treatment. Postoperative visual acuity was improved in 19 eyes and was unchanged in three eyes. The macular edema disappeared in 12 eyes and decreased in 10. Complications included a vitreous hemorrhage in 6 eyes, a paramacular tear in 1 eye, a reghmatogenous retinal detachment in 1 eye and cataract formation in 2 eyes. Vitreous surgery can improve the visual prognosis in cases of diabetic macular edema associated with a pathological vitreo-macular interface.
我们观察到一些患有糖尿病性黄斑水肿的患者，他们对格栅激光治疗无反应，但随着自发性玻璃体后脱离或玻璃体切除术而病情改善。这些病例的玻璃体-黄斑界面紧绷且有光泽。详细介绍三例此类病例。对22例患者进行了玻璃体后皮质分离的玻璃体切除术。他们均患有增殖性糖尿病视网膜病变，此前已接受全视网膜光凝治疗。14例患者黄斑格栅激光治疗无效。术后19只眼视力提高，3只眼视力未变。12只眼黄斑水肿消失，10只眼黄斑水肿减轻。并发症包括6只眼玻璃体出血、1只眼黄斑旁裂孔、1只眼孔源性视网膜脱离和2只眼白内障形成。对于伴有病理性玻璃体-黄斑界面的糖尿病性黄斑水肿病例，玻璃体手术可改善视觉预后。
