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广角视野系统在严重增生性糖尿病视网膜病变手术中的应用
Wide-angle viewing system in the management of severe proliferative diabetic retinopathy

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DOI:
作者:
朱颖 1,2, 赵培泉2
Ying Zhu 1,2，; Peiquan Zhao2
作者单位:
1 温州医学院 2 上海交通大学医学院附属新华医院眼科，200092 通讯作者：赵培泉
1 WenZhou Medical College 2 Department of ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai 200092
关键词:
广角视野系统；增生性糖尿病视网膜病变；玻璃体手术
Keywords: Wide-angle viewing system; Proliferative diabetic retinopathy; Vitrectomy.
摘要:
[摘要] 目的 探讨广角视野系统(wide-angle viewing system)在玻璃体手术治疗伴有广泛纤维血管增殖的严重增生性糖尿病视网膜病变(PDR)中的应用价值。方法 回顾性分析2008年1月至2009年12月在我院就诊的21例（28只眼）伴有广泛新生血管膜的严重PDR患者。患者平均年龄57.1岁(37-82岁)，随访时间平均为12.5月 (5–24月)。术中采用广角视野系统下玻璃体切除、剥膜、眼内电凝、视网膜复位、全视网膜光凝、气液交换、注气/硅油等附加术式。必要时联合四切口双手剥膜。结果 所有玻璃体手术过程均顺利。最终解剖复位成功率达100％，视力增加者22眼占78.6％，不变者5眼占17.9％，视力减退者1眼占3.6％。结论 广角视野系统为玻璃体手术提供了清晰、广角且正立的手术视野，尤其在双手剥膜、电凝止血、周边操作及全视网膜光凝等方面具有较大优势，在严重PDR手术中具有较高的安全性和实用性。
[Abstract] Purpose To evaluate the value and applicability of a wide-angle viewing system (WAVS) during vitrectomy in eyes with extensive fibrovascular membrane secondary to proliferative diabetic retinopathy (PDR). Methods In a retrospective, noncomparative, interventional study, 21 consecutive cases (28 eyes) of severe PDR with extensive fibrovascular membrane were submitted to vitrectomy using a WAVS between Jan 2008 and December 2009. Mean age of the patients was 57.1 years (range, 37–82 years). The patients were followed up for a mean of 12.5months (range, 5–24 months). The patients underwent vitrectomy using WAVS with four-port bimanual technique, peeling of fibrovascular membrane and/or internal limiting membrane, intraocular laser coagulation, air-fluid exchange, tamponading of air and expansive gases or silicon oil were performed according to the condition of diseases. Results The procedures were finished successfully in all patients. Postoperatively, retina was fully attached in all eyes, BCVA of 22 eyes (78.6％) had improved two lines, 5 eyes (17.9％) remained unchanged, and 1 eye(6.7％) decreased in vision. Conclusions The efficacy of vitrectomy using WAVS for severe PDR are satisfactory and comparable. We consider it more safe and effective during complicated surgical manipulations than using traditional vitrectomy system.

 

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