ABSTRACT
·AIM: To discuss the curative effect of extra-panretinal photocoagulation on proliferative diabetic retinopathy (PDR) during vitreous operation. ·METHODS:We conducted a retrospective analysis of 70 diabetic retinopathy patients (70 eyes) who accepted vitreous surgery in our hospital due to vitreous hemorrhage or vitreous retina traction change from March 2011 to March 2013. In follow-up clinics, according to the difference of patient's retinal photo-coagulation range, we divided it into extra - panretinal photocoagulation group (40 patients) and panretinal photocoagulation (30 patients),respectively observed the best corrected visual acuity,intraocular pressure and retinal vessel changes in two groups and made statistical analysis. ·RESULTS:Through comparing the eye condition,visual acuity after 3mo, intraocular pressure between the two groups patients, the difference had no statistical significance (all of the P>0.05). Comparing the incidence of retinal blood vessel leak, posterior pole exudate, and posterior pole bleeding points in two groups patients,the difference had statistically significant (all of the P<0.05). Comparing the incidence of no-perfusion area of retina, prepapillary vascular leak in two groups patients, the difference had statistically significant(P = 0. 04, 0. 02). Comparing the incidence of macular edema in two groups patients after operation,the difference had no statistically significance(P=1.00). Comparing the extinction time of macular edema,the difference had statistically significant (P<0.05), extra-panretinal photocoagulation group was better than panretinal photocoagulation.· CONCLUSION: To cure proliferation diabetic retinopathy, adopting the extra - panretinal photocoagulation has a better curative effect than panretinal photocoagulation on curing no-perfusion area of retina, retinal blood vessel leak, prepapillary vascular leak in operation on vitreous. However, the excessive retinal photocoagulation has a clear damage on retina and choroid. Therefore, in the treatment, while covering the retinopathy as far as possible, it is important to master the laser energy and spot number preventing the complications.
ABSTRACT
AIM: To observe the therapeutic effect and safety of improved extra panretinal photocoagulation ( E - PRP) in the treatment of high risk proliferative diabetic retinopathy (hsPDR). METHODS: A total of 88 consecutive cases (102 eyes) with hsPDR were diagnosed by fundus fluorescein angiography(FFA) from February 2011 to December 2014 in our hospital . Fifty two eyes had been treated by improved E - PRP with 532nm frequency - doubled laser. Fifty eyes had been treated by standard PRP. All cases were checked by FFA and fundus photocoagulation every 3mo. Patients with persisting neovascularization or non perfusion area were treated with laser again. All cases were followed up 6-36mo. RESULTS: The postoperative visual acuity had no statistical difference between two groups ( P > 0. 05). In improved E - PRP group, retinal non perfusion area and neovascularization disappeared in 35 eyes ( 67%). Effective rate was 88%. Six eyes (12%) underwent pars plana vitrectomy because of vitreous hemorrhage, fiberosis and stretched retinal detachment. In standard PRP group, retinal nonperfusion area and neovascularization disappeared in 23 eyes ( 46%). Effective rate was 66%. Seventeen eyes(34%) underwent pars plana vitrectomy because of anterior retina bleeding or vitreous hemorrhage. The rate of neovascularization disappeared and effective rate had statistical difference between two groups (P CONCLUSION: It is a safe and effective methods to treat hsPDR by improved E-PRP and it was more effective than traditional PRP.