| 目的 观察糖尿病视网膜病变患者早期行白内障人工晶体植入术后视网膜病变的发展情况，以及氩激光光凝治疗糖尿病视网膜病变（DR）的远期效果，探讨该类患者白内障手术和视网膜光凝治疗的时机，分析其联合治疗的效果。方法 我院合并白内障的糖尿病视网膜病变患者，符合纳入标准的病人共67例，以非手术眼作为对照。白内障术后经FFA随访观察，随访时间1年。当检查具有光凝指征时，均行氩激光视网膜光凝。对比观察手术眼和对照眼视网膜光凝前后的视网膜病变发展程度。结果 白内障术后手术眼和对照眼经FFA随访观察需行视网膜光凝分别为，26眼（41.94%）及眼24（38.71%），其视网膜病变发展程度基本一致；白内障人工晶体(IOL)植入手术后及时光凝的病人，DR病情稳定或减慢发展，黄斑水肿消退或减轻，视力稳定，手术眼比非手术眼获得更充分的视网膜光凝及稳定的视力和视觉质量，2例患者拒绝接受视网膜光凝治疗，晚期发生新生血管性青光眼及玻璃体出血。结论 完美的无并发症的白内障人工晶体植入手术不会加速DR的发展；及时充分的视网膜光凝治疗，将减缓DR的发展及减少其并发症(新生血管性青光眼、玻璃体出血)的发生，稳定视力。
【关键词】 白内障； 人工晶体； 糖尿病性视网膜病变
Diabetic retinopathy progression and photocoagulation opportunity after phacoemulsification: prospective study.
Qiaogang, Wang xiaoli, Daiyan,eta, Mianyang Central Hospital Sichuan Province,Mianyang,Sichuan,621000
ABSTRACT:
PURPOSE: To determine the incidence of diabetic retinopathy (DR) progression after phacoemulsification in patients with type II diabetes, and analysis effect of photo-coagulation for DR with argon laser. METHODS: This prospective study evaluated 67 patients with diabetes mellitus who had monocular phacoemulsification. A control group comprised the patients' contralateral eyes. Data analysis included preoperative and postoperative retinal findings and DR status with fluorescein fundus angiography(FFA). RESULTS: Postoperative visual acuity increased by 3 or more lines in operated eyes. Diabetic retinopathy in the operated eye progressed in 26 patients (41.94%) and in the fellow eye in 24 patients (38.71%) .Both operated eye and the fellow eye has the same DR progression (p>0.05) . Operated eye can get more sufficient retina photo-coagulation and stable acuity of vision. CONCLUSION: Uneventful phacoemulsification cataract surgery may not cause DR progression, promptly and sufficient photo-coagulation can slow down DR progression .
|
网友评论：（只显示最新10条。评论内容只代表网友观点，与本站立场无关！）