目的:探讨采用玻璃体切割联合白内障超声乳化及后房型人工晶状体植入术治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)合并白内障患者的临床效果。方法:对36例36眼合并白内障的增生性糖尿病视网膜病变患者行玻璃体切除联合白内障超声乳化人工晶状体植入手术,其中气体填充6眼,硅油填充4眼;观察术后视力改善程度及术中术后并发症。结果:手术后患者随访1~12(平均4.5)mo。术后36眼视力均有不同程度的改善,术后视力≥0.1有6眼(17%);0.02≤视力<0.1有24眼(67%),光感至数指有6眼(17%)。术中未发生严重的并发症。早期高眼压5眼(14%),虹膜后粘连3眼(8%),因后发性白内障行YAG激光后囊膜光切术12眼(33%)。1眼于术后1mo出现新生血管性青光眼(3%)。除高眼压患者,术后无明显角膜水肿或角膜内皮失代偿。术后未发生视网膜脱离和玻璃体出血。结论:玻璃体切除联合白内障超声乳化人工晶状体植入术治疗增生性糖尿病视网膜病变合并白内障患者是安全有效的。

AIM:To evaluate the effectiveness of combined pars plana vitrectomy(PPV)and phacoemulsification(PEA)with intraocular lens(IOL)implantation in patients with concomitant cataract and proliferative diabetic retinopathy(PDR).METHODS:This retrospective study consisted of 36 patients 36 eyes with PDR and cataract.PPV was combined with PEA and IOL implantation.Gas tamponade was employed in 6 eyes;silicone oil tamponade was employed in 4 eyes;postoperative visual acuity,complications were analyzed.RESULTS:The postoperative follow-up interval ranged from 1 to 12 months(an average of 4.5 months).The postoperative visual acuity was improved in different degrees:≥0.1 in 6 eyes(17%),0.02-0.1 in 24 eyes(67%),light perception to counting fingers in 6 eyes(17%).During operation,no severe complications occurred.After operation,there was early ocular hypertension in 5 eyes(14%),posterior synechia in 3 eyes(8%),posterior capsular opacity(PCO)in 12 eyes performed Nd:YAG capsulotomy(33%),and neovascular glaucoma in 1 eye(3%),but there was no retinal detachment,no vitreous hemorrhage or corneal edema.CONCLUSION:This study suggests that the combined operation of PPV,PEA and IOL implantation is safe and effective for PDR coexisting with cataract.

R779.6