Investigation Of The Efficacy And Surgical Methods On Proliferative Diabetic Retinopathy

ObjectiveProliferative diabetic retinopathy (PDR) is the main blind reason of diabetes people, it is also the vitrectomy common indications. PDR is associated with different degrees of cataract, timely vitrectomy can make patients get good visual acuity, at present, vitrectomy phacoemulsification and intraocular lenses implantation combined surgery has more and more applied in treatment, this paper retrospectively compared vitrectomy alone and vitrectomy combined with phacoemulsification and IOL implantation with regard to both complications and results.MethodsIn this study, we retrospectively compared vitrectomy combined with phacoemulsification and intraocular lens implantation26 patients (26 eyes) and vitrectomy alone 24 patients (24 eyes) regarding postoperative visual acuity intraoperative, intraoperative complications and postoperative complications. Compared group 26 patients (26 eyes), the age range from 32 to 82 years, the average is (60.4+10.8) years. Male in 10 cases, female 16 patients. Are all monocular surgery. Preoperative vision is light sensor～0.12, followed up from 10 to 30 months, the average is 20 months. Pure vitrectomy group 24 patients (24 eyes), the age range from 40 to 74 years old, the average is (59.6+9.1) years. Male in 12 cases, female 12 patients. Also for monocular surgery. Preoperative vision is manual～0.12, followed up from 11 to 31 months, the average is 21 months. Two groups of 50 patients who are have similar cataract degree, the 24 patients who are in pure vitrectomy group receive cataract phacoemulsification and intraocular lens implantation after vitrectomy after a period of time.ResultsFinal visual acuity of all cases were improved in the two groups, without significant difference. Postoperative fibrin formation were found in 6 eyes in the phacovitrectomy group and only 1 eye in the vitrectomy alone group, and there were no significant difference between them. Postoperative corneal edema were found in 10 eyes in the phacovitrectomy group and 3 eyes in the vitrectomy alone group.. The incidence was significantly lower(P<0.05) in the vitrectomy alone group. Postoperative neovascular glaucoma occurred in 2 eyes in the phacovitrectomy group and 1 eyes in the vitrectomy alone group, there were no significant difference between them. Five eyes occurred posterior synechia in the phacovitrectomy group and 1 eye in the vitrectomy alone group, and there were no significant difference between them. One eye required a repeat vitrectomy in the phacovitrectomy group, while 2 eyes in vitrectomy alone group, and there were no significant difference between them. One eye was found postoperative amotio retinae in the phacovitrectomy group and 3 eyes in the vitrectomy alone group, and there were no significant difference between them.Conclusion1. Vitrectomy combined with phacoemulsification and intraocular lens implantation is useful as an alternative surgical treatment for patients with PDR.2. The effect of pure vitrectomy for proliferative diabetic retinopathy is satisfactory. vitrectomy The patients who suffer PDR with vitreous hemorrhage or limited and traction retinal detachment can get good vision acuity when they receive the vitrectomy properly.3. Different patients should choose proper way reasonably according to the actual situation, patients can consider to receive combined surgery when cataract is severe, it may affect the vitreous surgery operation and influence postoperative therapy, at the same time, their economic situation allows. They need to have postoperative seasonable compensatory photocoagulation, to strive for best vision after the surgery.4. The incidence of anterior inflammatory reaction, posterior synechia of iris and corneal edema is high in compared surgery group, compared with pure vitrectomy group, we can timely take symptomatic treatment to ensure forward effect.