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《合并白內(nèi)障的增殖性糖尿病視網(wǎng)膜病變聯(lián)合手術(shù)效果及并發(fā)癥的觀察》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
1、合并白內(nèi)障的增殖性糖尿病視網(wǎng)膜病變聯(lián)合手術(shù)效果及并發(fā)癥的觀察作者:劉瑞菊,安良寶,張欣,何偉【摘要】目的探討合并白內(nèi)障的增生性糖尿病視網(wǎng)膜病變(proliferativediabeticretinopathy,PDR)玻璃體切除聯(lián)合超聲乳化人工晶狀體植入術(shù)的臨床效果及并發(fā)癥。方法回顧性分析2006年3月至2010年1月本院手術(shù)治療的合并白內(nèi)障的增生性糖尿病視網(wǎng)膜病變患者228例(236只眼)。其中男108例,女120例;年齡39~76歲,平均57歲;糖尿病史2~26年,眼病史1月至8年。結(jié)果術(shù)后平均隨訪
2、時(shí)間分別為6~16個(gè)月。患者手術(shù)后視力較術(shù)前提高198眼(占86.8%),不變15眼(占6.6%),術(shù)后視力下降或光感消失15眼(占6.6%);術(shù)后前房?jī)?nèi)纖維素滲出膜形成有76眼(占33.3%),觀察1w~3個(gè)月完全吸收的有65眼(占85.5%);術(shù)后角膜水腫、上皮愈合慢有52只眼(占22.8%),有1例經(jīng)3個(gè)月的營(yíng)養(yǎng)角膜治療,最終恢復(fù)正常;術(shù)后發(fā)生后囊膜混濁(后發(fā)障)156眼(占68.4%),于取油同時(shí)處理,不注油者單行YAG激光切除;術(shù)后網(wǎng)膜再增殖,牽引網(wǎng)脫,或玻璃體再積血者16例(占7.0%),均
3、再行玻璃體切割術(shù)聯(lián)合剝膜、注油。結(jié)論玻璃體切除聯(lián)合超聲乳化白內(nèi)障摘除人工晶狀體植入術(shù)治療增殖性糖尿病視網(wǎng)膜病變是安全、有效的,術(shù)后并發(fā)癥少,能迅速恢復(fù)患者視力,減少患者多次手術(shù)的痛苦。10【關(guān)鍵詞】超聲乳化術(shù);玻璃體切除術(shù);增生性糖尿病視網(wǎng)膜病變;白內(nèi)障;手術(shù)效果;并發(fā)癥 Abstract:ObjectiveToexploretheefficacyandcomplicationsofvitrectomycombinedwithphacoemulsificafionandintraocularlensi
4、mplantationforthetreatmentofproliferativediabeticretinopathy(PDR)andcataract.MethodsAretrospectiveanalysiswasdoneto228patients(236eyes)withPDRandcataractfromMarch2006tillJanuary2010.Amongthem,108patientsweremale,and120patientswerefemale.Theyvariedinagefr
5、om39to76year-old,andtheaverageagewas57.Thehistoryofdiabetesmellituswas2~26years,andwithPDRforonemonthtoeightyears.ResultsAtotalof236eyeswerefollowedupfor6~16months.Visualimprovementwasachievedin198eyes(86.8%),thesamewithpreoperationin15eyes(6.6%),anddecl
6、inedordisappearedoflightperceptionin15eyes(6.6%).76eyes(33.3%)werefoundafteroperationwithcelluloseexudationmembraneinanteriorchamber,ofthose65eyes(85.5%)wereabsorbedinfromoneweektothreemonths.Corneaedemaanddelayedhealingofcorneaepithelialcellwerefoundin5
7、2eyes(22.8%),ofthoseoneeyewascuredinthreemonths.posteriorcapsuleopacificationwerefoundin156eyes10(68.4%),andbeingremovedwithtakingsiliconeoilorbyYAG.16patients(7.0%)werefoundafteroperationwithretinalproliferationandtractionaldetachmentorblooddepositinvit
8、reousbody,andalltheeyesweredonevitrectomycombinedwithstrippingmembraneandsiliconeoiltamponade.ConclusionsThesurgeryofvitrectomycombinedwithphacoemulsificafionandintraocularlensimplantationforthetreatmentofproliferativediab