【摘要】 目的 探讨玻璃体切割术治疗增殖性糖尿病视网膜病变的时机和疗效。方法 回顾186例（242眼）PDR患者资料，123眼行全视网膜光凝术，119眼行玻璃体切割术，对手术时机和治疗效果进行对比分析。术后随访6 40个月。结果 PDRⅣ期、Ⅴ期患者行玻璃体切割手术后视力改善的比例为78.4%，Ⅵ期患者为43.7%；PDRⅣ期患者行全视网膜光凝术治疗后有效率为80.8%，Ⅴ期患者为58.2%；未合并玻璃体出血的Ⅴ期PDR患者，PRP治疗有效率为58.2%，而玻璃体切割术后视力改善者占78.9%。术中并发症主要是医源性裂孔，术后并发症为玻璃体再出血、视网膜脱离、新生血管性青光眼。结论 正确把握PDR患者行全视网膜光凝术和玻璃体切割术的时机，才能提高疗效，有效地改善PDR患者的视力。
【关键词】 增殖性糖尿病视网膜病变 玻璃体切割术 时机
CHEN Fang, ZHUANG Chaorong, ZHAO ming, YE dongsheng
（Department of Ophthalmology, School of Medicine, Yangzhou University, Yangzhou 225001, Jiangsu, China）
Abstract: Objective To explore the occasion choice and efficacy of vitrectomy for treatment of proliferative diabetic retinopathy(PDR). Methods 186 patients (242 eyes) with PDR were enrolled in this study. Panretinal photocoagulation (PRP) was performed on 123 eyes and vitrectomy on 119 eyes. All were followed up for 6 to 40 months. Results After vitrectomy, visual acuity was improved in 78.4% eyes of the Ⅳ and ⅤPDR groups and 43.7% of the Ⅵ PDR group. After PRP, visual acuity was improved in 80.8% eyes of theⅣ PDR group and 58.2% of the Ⅴ PDR group. For Ⅴ PDR patients without vitreous hemorrhage, the effective rate of vitrectomy treatment was 78.9% while of PRP it was 58.2%. The main operative complication was iatrogenic retinal holes and the postoperative complications were vitreous rehemorrhage, retinal detachment and neovascular glaucoma. Conclusion A suitable operative occasion is important for patients with PDR to ensure good visual acuity.
Key words: Proliferative diabetic retinopathy; Vitrectomy; Occasion choice 增殖性糖尿病视网膜病变（proliferative diabetic retinopathy， PDR）是糖尿病的严重并发症之一。目前治疗PDR的有效方法是全视网膜光凝术（panretinal photocoagulation，PRP）和玻璃体切割术［1，2］。现对我院186例PDR患者行玻璃体切割术的时机和治疗效果，进行回顾分析。
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