Comparison of Vitrectomy Alone and Combined Vitrectomy, Phacoemulsification and Intraocular Lens Implantation for Proliferative Diabetic Retinopathy

比較增殖性視網膜病變眼接受單獨玻璃體切除術以及玻璃體切除術合併超音波晶體乳化術及人工水晶體植入術之預後

曾漢儀(Han-Yi Tseng) ； 吳文權(Wen-Chuan Wu) ； 徐聖曜(Sheng-Yao Hsu)

《The Kaohsiung Journal of Medical Sciences》 23卷7期 (2007/07) Pp. 339-343

摘要

過去認為增殖性糖尿病視網膜病變患者在接受水晶體摘除手術後易發生虹膜新生血管變化，本研究採回溯方法比較此類患者接受單純玻璃體切除手術以及同時合併接受超音波乳化水晶體摘除術和人工水晶體植入術後併發症及預後是否不同。共有五十三眼接受單純玻璃體切除術，三十一眼接受玻璃體切除合併水晶體摘除手術。術後產生虹膜以及隅角新生血管分別有8(15.1%)及0(0%)眼，合併水晶體摘除者發生率較低且有顯著差異。最終視力進步大於一行以上者分別有17(32.1%)以及21(67.7%)眼，而接受合併手術者視力有較顯著的進步。我們認為兩種手術合併進行對同時有增殖性糖尿病視網膜病變以及白內障的患者是另外一種不錯的手術選擇。

關鍵字

虹膜新生血管 ； 增殖性糖尿病視網膜病變 ； 玻璃體切除術

並列摘要

There have been concerns that there may be an increased incidence of iris neovascularization (NV) following lens removal in patients with proliferative diabetic retinopathy (PDR). In this study, we retrospectively compared vitrectomy alone and vitrectomy combined with phacoemulsification (phacovitrectomy) and intraocular lens implantation regarding both complications and results. Fiftythree eyes for vitrectomy group and 31 eyes for phacovitrectomy group were included. Postoperativ iris and angle NV were found in eight (15.1%) eyes in the first group and no (0%) eyes in the second. The incidence was significantly lower (p＜0.05) in the phacovitrectomy group. The final vision gain of one or more lines was found in 17 (32.1%) and 21 (67.7%) eyes, respectively. There was significantly better vision improvement in the phacovitrectomy group. We consider the combined procedure to be useful as an alternative surgical treatment for patients with PDR and cataract formation.

並列關鍵字

iris neovascularization ； proliferative diabetic retinopathy ； vitrectomy