目的:评价玻璃体切除联合晶状体超声乳化及人工晶状体植入术治疗增生性糖尿病视网膜病变(PDR)的疗效及并发症。方法:回顾性分析55例68眼伴有白内障的PDR患者行玻璃体切除联合晶状体超声乳化及人工晶状体植入术的临床资料,观察术后视力改善程度及术中、术后并发症。结果:术后随访3～24(平均8.5)mo。51眼(75%)术后视力维持或改善,17眼(25%)视力下降,其中无光感6眼(9%);术中并发症为医源性视网膜裂孔15眼(22%);术后并发症:前房炎性反应30眼(44%),玻璃体积血11眼(16%),复发性视网膜脱离3眼(4%),虹膜红变5眼(7%),新生血管性青光眼2眼(3%);31眼(46%)术后需要继续眼内光凝。结论:玻璃体切除联合晶状体超声乳化及人工晶状体植入术治疗PDR,可使大多数患者的视力改善,手术是安全的,手术成功的关键为选择合适的患者,影响术后视力的主要因素为视网膜病变程度。

AIM:To investigate the efficacy and complications of phacoemulsification combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract. ·METHODS:Retrospectively analyzed the information of 55 patients 68 eyes with cataract and proliferative diabetic retinopathy,which were treated with vitrectomy com-bined lens phacoemulsification and intraocular lens im-plantation,the postoperative visual acuity and compli-cations in and after operation were observeed. ·RESULTS:The follow-up period was 3-24 months with the average of 8.5 months. Postoperative visual acuity improved or remained unchanged in 51 eyes (75% ); and decreased in 17 eyes (25% ). Complication in operation is iatrogenic retinal tear in 15 eyes (22%). Postoperation complications consisted of anterior chamber fibrin exudation in 30 eyes (44% ); vitreous hemorrhage in 11 eyes (16%); retinal detachment in 3 eyes (4%); rubeosis of iris in 5 eyes (7%); neovascular glaucoma in 2 eyes (3%). Retinal photocoagulation was performed in 31(46%) eyes after surgery. ·CONCLUSION:Vitrectomy combined lens phacoemul-sification and intraocular lens implantation to treat cataract proliferative diabetic retinopathy is safe and efficient,which can improve the visual acuity of majority of patients. The key point is to select suitable patients and the key influencing factor of postoperative visual acuity is the degree of retinal damage.

R779.6