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目的:探讨玻璃体视网膜手术对糖尿病视网膜病变(diabetic retinopathy,DR)激光光凝术后玻璃体积血的疗效。方法:对本院2000—2005年因DR而行激光光凝术后发生中度以上玻璃体积血的患者59例62眼行玻璃体视网膜手术,术中补眼底激光。追踪随访6~38个月,平均18个月。结果:玻璃体视网膜手术后0.1以上视力者51眼,占82.26%,0.02以上视力者62眼,占100%,术后视力明显好于术前视力(P<0.01)。术后获得0.5及以上视力者9眼,在积血病程≤6个月组高于>6个月组,但二者之间无统计学意义(P>0.05)。手术并发症包括玻璃体再积血1眼(1.61%)、并发白内障23眼(50%)、暂时性高眼压6眼(9.68%)、角膜水肿6眼(9.68%)、葡萄膜炎4眼(6.45%)及医源性视网膜裂孔5眼(8.07%)。结论:DR激光光凝术后玻璃体积血患者行玻璃体视网膜术后可获得良好的视力,无严重并发症发生。
Objective: To investigate the effect of vitreoretinal surgery on vitreous hemorrhage after laser photocoagulation of diabetic retinopathy (DR). Methods: From January 2000 to December 2005, 59 patients (62 eyes) with vitreous hemorrhage who had moderate to severe vitreous hemorrhage after laser photocoagulation in our hospital underwent vitreoretinal surgery. Follow-up 6 to 38 months, an average of 18 months. Results: There were 51 eyes with visual acuity of more than 0.1 after vitreoretinal surgery, accounting for 82.26%, 62 eyes with visual acuity of 0.02 or above, accounting for 100%. Postoperative visual acuity was significantly better than preoperative visual acuity (P <0.01). There were 9 eyes with visual acuity of 0.5 or above after operation, which was higher than 6 months in patients with hemorrhage ≤ 6 months, but there was no significant difference between them (P> 0.05). The complications included vitreous hemorrhage in 1 eye (1.61%), cataract in 23 eyes (50%), temporary intraocular hypertension in 6 eyes (9.68%), corneal edema in 6 eyes (9.68%), uveitis (6.45%) and iatrogenic retinal holes (8.07%). Conclusion: Patients with vitreous hemorrhage after DR laser photocoagulation can get good visual acuity after vitreoretinal surgery without serious complications.