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[摘要]
目的：观察严重增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)患者玻璃体手术和全视网膜光凝的视力对比。
方法：将我院93例严重PDR患者随机分为两组，一组接受玻璃体切除+剥膜+全视网膜光凝+黄斑光凝； 另一组接受全视网膜光凝+黄斑光凝，随访1a。
结果：术后1a，第一组，视力提高12眼(27.9%)，不变11眼(25.6%)，下降20眼(46.5%)。第二组，提高14眼(28.0%)，不变24眼(48.0%)，下降12眼(24.0%)。两组间视力提高比例无差异。但不变和下降比例差异有显著意义。
结论：对于严重的PDR患者，玻璃体切除术可能会带来更高视力下降的风险。
[Key word]
[Abstract]
AIM: To observe the visual acuity after pars plana vitrectomy(PPV)and panretinal photocoagulation in severe proliferative diabetic retinopathy(PDR).
METHODS: Totally 93 cases with severe PDR were randomly divided into 2 groups. Group 1 were treated with PPV + membrane peeling +panretinal photocoagulation +focal or grid macular laser. Group 2 were treated with panretinal photocoagulation + focal or grid macular laser. Follow-up was at least 12 months.
RESULTS: At postoperative one year, visual acuity in group 1 improved in 12 eyes(27.9%), unchanged in 11 eyes(25.6%), decreased in 20 eyes(46.5%). In group 2, visual acuity improved in 14 eyes(28.0%), unchanged in 24 eyes(48.0%), decreased in 12 eyes(24.0%). The percentage of improvement in 2 groups has no statistical significant difference, whereas the stabilized and worsened eyes in group 1 and group 2 were significantly different.
CONCLUSION: PPV may worsen the visual acuity of the patients with severe PDR, compared with the panretinal photocoagulation.
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