Long-Term Outcome of Vitreous Surgery for Proliferative Diabetic Retinopathy

以玻璃體切除術治療增殖性糖尿病視網膜病變之長期結果

汪志舜(Chih-Shun Wang) ； 李鳳利(Feng-Lih Lee) ； 林嘉理(Chia-Lee Lin) ； 蔡三章(San-Chang Tsai) ； 林伯剛(Po-Kang Lin) ； 楊昌叔(Chang-Sue Yang) ； 陳世真(Shih-Jen Chen) ； 劉榮宏(Jorn-Hon Liu)

《中華民國眼科醫學會雜誌》 41卷2期 (2002/06) Pp. 129-134

https://doi.org/10.30048/ACTASOS.200206.0007

摘要

背景：增殖性糖尿病視網膜病變為已開發國家病人視力喪失主要原因之一。本篇研究回溯以玻璃體手術治療增殖性糖尿病視網膜病變併發症之長期視力預後及手術併發症。
方法：由1992年1月至1997年12月共收集367個病人，436隻因增殖性糖尿病視網膜病變併發症而進行玻璃體切除術的眼睛。
結果：手術之適應症包括玻璃體出血(60.3%)，玻璃體出血合併牽引性視網膜剝離(19.7%)，牽引性視網膜剝離(18.3%)，合併裂孔性及牽引性視網膜剝離(0.5%)，及進行性纖維血管增生(1.1%)。術後最佳矯正視力有63%的眼睛獲得進步，6%維持不變，31%變差。最後視力有46.6%可達0.05以上，23.4%可達0.2以上。最常見之手術中併發症為醫原性視網膜裂孔(11.1%)。最常見之手術後併發症為復發性玻璃體出血(23.4%)。
結論：依本研究之結果，大多數患有增殖性糖尿病視網膜病變併發症之病人均可經由玻璃體手術得到有效治療。

並列摘要

Background. Proliferative diabetic retinopathy (PDR) is one of the most prevalent causes of blindness in developed countries. This retrospective study evaluated the long-term visual outcomes and complications of vitrectomy resulting from various PDR complications.
Methods. A review of 436 eyes (367 patients) treated with pars plana vitrectomy for complications of PDR was conducted for the period of 1992 to 1997 at the Veterans General Hospital-Taipei.
Results. Indications for surgery were: (1) vitreous hemorrhage, 263 eyes (60.3%); (2) vitreous hemorrhage and tractional retinal detachment, 86 eyes (19.7%); (3) tractional retinal detachment, 80 eyes (18.3%); (4) combined tractional and rhegmatogenous retinal detachment, 2 eyes (0.5%); (5) progresssive fibrovascular proliferation, 5 eyes (1.1%). Best postoperative visual acuity was improved for 274 eyes (63%), unchanged for 27 eyes (6%), and worse for 135 eyes (31%). Postoperative results yielded 203 eyes (46.6%) that had final vision of 3/60 or better, and 102 eyes (23.4%) that had 6/30 or better. The most common intraoperative complication was iatrogenic retinal tear (11.1%) while the most common postoperative complication was recurrent vitreous hemorrhage (23.4%).
Conclusions. More than half of the cases with complications of proliferative diabetic retinopathy could be effectively treated with vitreous surgery.

並列關鍵字

proliferative diabetic retinopathy ； vitreous surgery