方法：回顾性病例分析。共计纳入2013-04/2014-08在北京协和医院眼科诊治的PDR患者52例52眼。试验组23眼在玻璃体切除术前6～14d行雷珠单抗玻璃体腔注药0.5mg，对照组29眼单纯行玻璃体切除手术。对比两组患者手术时间、术中出血、医源性破孔、手术填充物类型、再次手术率，以及术前、术后、末次随访时的视力情况等。

结果：手术时间：试验组70.52±26.18min，对照组99.45±27.75min，两组比较差异有显著统计学意义(t=-3.827，P=0.000)； 手术中出血：试验组5眼(21.7%)，对照组19眼(65.5%)，两组比较差异有显著统计学意义(χ²=9.892，P=0.002)； 术中医源性破孔：试验组3眼(13.0%)，对照组15眼(51.7%)，两组比较差异有显著统计学意义(χ²=8.479，P=0.004)。术中硅油填充：试验组8眼(34.8%)，对照组19眼(65.5%)，两组比较差异有统计学意义(χ²=4.854，P=0.028)。玻璃体腔注射后未发生相关并发症。两组术前视力、术后视力比较差异无统计学意义(t=-1.659，-0.084； P=0.103，0.933)； 两组末次随诊视力比较差异有统计学意义(t=-2.662，P=0.010)。末次随诊视力≥0.1，试验组20眼(86.9%)，对照组16眼(55.2%)。

结论：玻璃体腔注射雷珠单抗辅助PDR玻璃体手术可以易化手术操作，退化新生血管，减少术中出血和医源性破孔的发生率，并且大大缩短手术时间，最终达到提高患者视力的目的。

METHODS: In this retrospective research, 52 patients(52 eyes)with PDR in Peking Union Medical College Hospital from April 2013 to August 2014 were recruited. The experimental group included 23 eyes treated with ranibizumab intravitreal injection, 0.5mg, 6～14d before vitrectomy, and 29 eyes underwent direct vitrectomy were analyzed as control group. Main outcome measures were surgical time, intraoperative hemorrhage, incidence of iatrogenic retinal breaks, types of tamponade, and percentage of reoperation were recorded. Visual acuity at pre-operative, post-operative and last follow-up were observed.

RESULTS: Mean surgical time was 70.52±26.18min in experimental group vs 99.45±27.75min in control group(t=-3.827, P=0.000); intraoperative bleeding 5 eyes(21.7%)vs 19 eyes(65.5%),(χ²=9.892, P=0.002); iatrogenic retinal breaks 3 eyes(13.0%)vs 15 eyes(51.7%),(χ²=8.479, P=0.004); silicone oil tampanade 8 eyes(34.8%)vs 19 eyes(65.5%),(χ²=4.854, P=0.028). No complications were recorded after intravitreal ranibizumab. Post-operative visual acuity and visual acuity at last follow-up elevated to some extent contrast to pre-operative visual acuity, there were 20 eyes(86.9%)in experimental group which visual acuity at last follow-up ≥0.1 vs 16 eyes(55.2%)in control group. Mean pre-operative visual acuity, post-operative visual acuity were not significantly different separately(t=-1.659,

-0.084; P=0.103, 0.933); visual acuity at last follow-up was significantly different between two groups(t=-2.662, P=0.010).

CONCLUSION: Ranibizumab intravitreal injection as an adjunct before vitrectomy in the treatment of patients with PDR can facilitate vitrectomy procedures, reduce active neovascularization, minimize the incidence of intraoperative haemorrhage and iatrogenic retinal breaks and shorten the operation time significantly, finally, benefits in improving visual outcome.