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目的 探讨玻璃体手术治疗中、晚期 PVR的疗效及减少并发症的处理措施。方法 5 2例 5 9只眼 PDR,其中 DR 期 2 4只眼 ,DR 期 35只眼。观察术后视力变化及各种并发症 ,术后随访 5个月至 6年。结果 4 7只眼视力提高 ,10只眼无变化 ,2只眼视力下降。病程长增殖严重 ,黄斑变性视力增进困难。结论 玻璃体切除是治疗中、晚期 PDR的有效方法。减少手术并发症的关键为控制血糖 ,术者手术技巧娴熟 ,尽量处理干净新生血管膜 ,松解视网膜。减少医源性裂孔的发生 ,电凝 /光凝充分止血 ,减少组织水肿、缺血。酌情环扎、加垫、气体 /硅油填充提高视网膜的解剖复位率
Objective To investigate the curative effect of vitreous surgery in the treatment of advanced PVR and its treatment measures to reduce the complications. Methods Fifty-two patients (59 eyes) had PDR, including 24 eyes in DR period and 35 eyes in DR period. Postoperative visual acuity and various complications were observed. The patients were followed up for 5 months to 6 years. Results In 47 eyes visual acuity improved, 10 eyes had no change and 2 eyes had decreased visual acuity. Prolongation of a long course of disease, macular degeneration, visual acuity difficulties. Conclusion Vitrectomy is an effective method for the treatment of middle and late stage PDR. Reduce the surgical complications of the key to control blood sugar, surgeon surgical skill, try to deal with clean neovascular membrane, release the retina. To reduce the occurrence of iatrogenic hiatus, electrocoagulation / photocoagulation fully stop bleeding, reduce tissue edema, ischemia. As appropriate, cerclage, padding, gas / silicone oil filled the retina to improve anatomic reduction rate