目的：比较激光光凝与激光光凝联合雷珠单抗治疗糖尿病性黄斑水肿的疗效。

方法：随机对照研究。纳入糖尿病性黄斑水肿患者134例180眼，随机分为试验组和对照组。两组患者年龄、性别、病程、BCVA、IOP、CMT均无差异(P>0.05)。试验组接受黄斑格栅光凝联合玻璃体腔注射雷珠单抗，对照组接受黄斑格栅光凝。治疗后1wk，3mo测量两组BCVA、IOP、CMT并进行比较。

结果：治疗前、治疗后1wk，3mo，两组IOP比较均无差异(P>0.05)。治疗1wk，3mo，试验组CMT均低于对照组(t=-7.83、-8.80，均P<0.05)。治疗1wk，3mo，试验组BCVA均优于对照组(t=-3.76、-4.09，均P<0.05)，治疗1wk试验组BCVA即显著提高(t=1.97，P<0.05)。试验组复发率低于对照组(χ²=4.59，P=0.032)。两组早期高眼压发生率无差异(χ²=0.03，P=0.87)。均未出现视网膜脱离、眼内炎。

结论：激光光凝联合雷珠单抗比单用激光光凝显著降低术后CMT，并较早提高BCVA，降低复发率。

METHODS: The research was based on the randomized controlled trial(RCT). A total of 180 eyes from 134 cases diagnosed with DME were randomly divided into experimental group and control group. No statistically significant difference was found between two groups(P>0.05)with respect to age, sex, duration of disease, best corrected visual acuity(BCVA), the mean intraocular pressure(IOP)and the mean central macular thickness(CMT). Patients in the control group received the photocoagulation while the combination therapy of both laser photocoagulation and ranibizumab were employed in the experimental group. BCVA, IOP and CMT were assessed at 1wk and 3mo after treatment, and the collecting data of two groups were examined.

RESULTS: Before treatment, 1wk and 3mo after treatment, there was no significant difference of IOP(P>0.05). 1wk and 3mo after treatment, the CMT in the experimental group was significantly lower than the other(t= -7.83, -8.80, P<0.05), whilst the BCVA in the experimental group was significantly higher than that in the control group(t= -3.76, -4.09, P<0.05). The BCVA of the experimental group was increased after 1wk treatment(t=1.97, P<0.05). The recurrence rate of the experimental group was lower(χ²=4.59, P<0.05). There were no significant differences in the incidence of early intraocular pressure between the two groups(χ²=0.03, P>0.05). No retinal detachment or intraocular inflammation occurred in both groups.

CONCLUSION: Compared with the laser photocoagulation, the combination therapy of laser photocoagulation and ranibizumab could significantly lower the CMT after surgery, early improve the BCVA and decrease the recurrence rate.