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玻璃体切割联合白内障超声乳化吸除及人工晶状体植入术治疗增生性糖尿病视网膜病变并发症的手术效果

Surgical results of pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation for complications of proliferative diabetic retinopathy.

作者信息

Honjo M, Ogura Y

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Japan.

出版信息

Ophthalmic Surg Lasers. 1998 Feb;29(2):99-105.

PMID:9507252
Abstract

BACKGROUND AND OBJECTIVE

To evaluate the effectiveness and safety of combining phacoemulsification (PEA), pars plana vitrectomy (PPV), and intraocular lens (IOL) implantation.

PATIENTS AND METHODS

Combined operations of PEA and PPV were performed in 76 eyes of 54 patients with cataract complicated by proliferative diabetic retinopathy (PDR). The mean follow-up period was 24.4 months. Gas tamponade was employed in 15 eyes. IOLs were implanted during surgery.

RESULTS

Visual acuity improved by 2 lines or more in 59 eyes (78%). Forty-seven eyes (77%) without tamponade and 12 eyes (80%) with tamponade had improved visual acuity. Postoperative complications included fibrin reaction in 8 eyes (10%), posterior synechia of the iris in 11 eyes (14%), and recurrence of retinal detachment in 8 eyes (10%). The incidence of these complications and of additional operations was higher in eyes that required tamponade, which corresponded with the severity of each case and the complexity of the surgical procedures.

CONCLUSIONS

Although further studies are indicated, this study suggests that the combined operation of PPV, PEA, and IOL implantation is safe and effective for patients with PDR. The choice of IOL may be correlated with postoperative complications.

摘要

背景与目的

评估超声乳化白内障吸除术(PEA)、玻璃体切割术(PPV)和人工晶状体(IOL)植入联合手术的有效性和安全性。

患者与方法

对54例患有增殖性糖尿病视网膜病变(PDR)并伴有白内障的患者的76只眼进行了PEA和PPV联合手术。平均随访时间为24.4个月。15只眼采用了气体填充。手术期间植入了人工晶状体。

结果

59只眼(78%)的视力提高了2行或更多。47只未进行填充的眼(77%)和12只进行填充的眼(80%)视力得到改善。术后并发症包括8只眼(10%)出现纤维蛋白反应,11只眼(14%)出现虹膜后粘连,8只眼(10%)视网膜脱离复发。这些并发症和额外手术的发生率在需要填充的眼中更高,这与每个病例的严重程度和手术操作的复杂性相关。

结论

尽管需要进一步研究,但本研究表明,PPV、PEA和IOL植入联合手术对PDR患者是安全有效的。人工晶状体的选择可能与术后并发症相关。

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