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目的评价玻璃体视网膜手术治疗晚期糖尿病性视网膜病变(PDR)伴黄斑脱离的临床效果。方法回顾分析接受玻璃体视网膜手术治疗的60例6期(视网膜全脱离)PDR患者72眼的临床资料。手术方式为玻璃体切割联合或不联合晶状体摘除,术中均注入惰性气体或硅油。视网膜解剖复位的标准以黄斑复位为视网膜复位成功,黄斑未复位为复位失败。手术后行黄斑区OCT检查并随访1年。结果手术后42眼一次性视网膜复位成功,占58.33%;30眼视网膜复位失败,占41.67%。手术后视力为无光感者3眼,占4.17%,较术前增加3眼;光感者18眼,占25.00%,较术前减少24眼;手动者26眼,占36.11%,较术前增加5眼;数指/10 cm~0.1者20眼,占27.78%,较术前增加11眼;≥0.1者5眼,占6.94%,较术前增加5眼。结论晚期PDR伴黄斑区脱离的患者行玻璃体视网膜手术难度较大,术后解剖复位率较高,但视功能恢复较差。
Objective To evaluate the clinical efficacy of vitreoretinal surgery in the treatment of advanced diabetic retinopathy (PDR) with macular detachment. Methods The clinical data of 72 eyes of 60 patients with stage 6 (total retinal detachment) PDR undergoing vitreoretinal surgery were retrospectively analyzed. The surgical approach is vitrectomy combined with or without lens extraction, intraoperative injection of inert gas or silicone oil. Retinal anatomical reduction of the standard reset to the retina for the success of the retina, macular reset is not reset failure. Postoperative macular OCT examination and follow-up 1 year. Results After the operation, 42 eyes had a one-time retinal reattachment successfully, accounting for 58.33%; 30 eyes failed to reattachment, accounting for 41.67%. The postoperative visual acuity was 3 with no light perception, accounting for 4.17%, an increase of 3 eyes compared with preoperative; 18 eyes with light perception, accounting for 25.00%, 24 eyes less than before surgery; 26 eyes with manual operation, accounting for 36.11% There were 5 eyes before the surgery, 20 eyes with the number of 10 cm ~ 0.1, accounting for 27.78%, 11 eyes more than preoperative, 5 eyes ≥ 0.5, accounting for 6.94%, 5 eyes more than preoperative. Conclusions Patients with advanced PDR with macular detachment are more difficult to perform vitreoretinal surgery and postoperative anatomic reduction rate is higher, but their visual function recovery is poor.