糖尿病视网膜病变行玻切手术不同时期植入人工晶体的临床观察

发布时间：2018-07-10 10:33

本文选题：增殖性糖尿病视网膜病 + 玻璃体切除术　；参考：《大连医科大学》2011年硕士论文

【摘要】：目的:探讨增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的患者行硅油取出+人工晶体(Intraocular lens,IOL)植入术和二次人工晶体植入术的临床疗效。方法设计:回顾性分析2009年3月至2011年3月在本院经同一手术医师治疗的因糖尿病视网膜病变行玻璃体切除+白内障超声乳化摘除+硅油注入术的患者45例(52只眼),男17例,女28例,年龄35-74岁,平均年龄58岁,患者均行过经典三通道玻璃体切除+白内障超声乳化摘除+硅油注入术,其中行硅油取出+人工晶体植入的患者26例(30只眼,其中双眼4例8只眼,右眼10例10只眼,左眼12例12只眼),行二次人工晶体植入术者19例(22只眼,其中双眼3例6只眼,右眼8例8只眼,左眼8例8只眼),糖尿病视网膜病变病程最短4年,最长24年,平均9.2年。术后随访2年,平均8个月。观察行两种不同术式的患者视力改善程度。结果:行硅油取出+人工晶体植入术的患者视力改善22只眼,占76.6%,行二次人工晶体植入的患者视力改善眼15只眼,占73.2%,两组术后视力改善眼数比较差异不显著(X2=0.08,P=0.995).52只眼均未发生严重并发症,医源性视网膜裂孔术中予以眼内光凝,术中活动性出血通过眼内光凝或术中升高灌注瓶止血。结论:在增生性视网膜病变患者的玻璃体手术中,硅油取出+人工晶体植入术和二次人工晶体植入术均可使大多数患者视力改善,两种术后视力改善程度无明显差异。
[Abstract]:Objective: to investigate the clinical effect of silicone oil extraction and intraocular lens implantation in patients with proliferative diabetic retinopathy (proliferative diabetic retinopathy). Methods: from March 2009 to March 2011, 45 patients (52 eyes) with phacoemulsification and silicone oil injection for diabetic retinopathy treated by the same surgeon in our hospital were analyzed retrospectively. 28 female patients (35-74 years old, mean 58 years old) underwent classic three-channel vitrectomy, phacoemulsification and silicone oil injection, among which 26 patients (30 eyes) underwent silicone oil extraction and intraocular lens implantation. Among them, 4 eyes (8 eyes), 10 eyes (10 eyes), 12 eyes (12 eyes) were treated with intraocular lens implantation (22 eyes), including 3 eyes (6 eyes) and 8 eyes (8 eyes). The course of diabetic retinopathy was the shortest 4 years, the longest 24 years (mean 9.2 years). Postoperative follow-up 2 years, average 8 months. The visual acuity of patients undergoing two different procedures was observed. Results: the visual acuity of the patients undergoing silicone oil extraction and intraocular lens implantation was improved in 22 eyes (76. 6%), while that of the second IOL implantation was improved in 15 eyes. There was no significant difference in the number of eyes with improved visual acuity between the two groups (X _ 2o _ (0.08) P _ (0.995) .No serious complications occurred in 52 eyes. Intraocular photocoagulation was performed during iatrogenic retinal rupture, and intraoperative bleeding was stopped by intraocular photocoagulation or increased perfusion bottle during operation. Conclusion: in vitreous surgery of proliferative retinopathy, silicone oil extraction intraocular lens implantation and secondary intraocular lens implantation can improve the visual acuity of most of the patients, but there is no significant difference between the two kinds of postoperative visual acuity.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.66

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