ABSTRACT
@#AIM: To observe the clinical effect of conbercept combined with 25G minimally invasive vitrectomy in the treatment of proliferative diabetic retinopathy(PDR), and analyze the influencing factors of postoperative vitreous rehaemorrhage.<p>METHODS: Totally 179 eyes of 179 PDR patients confirmed and treated in our hospital from 2017-04/2019-11 were selected and grouped according to patients' condition and intention. 108 patients in the observation group underwent conbercept combined with 25G minimally invasive vitrectomy, while 71 patients in the control group underwent 25G minimally invasive vitrectomy only. The baseline data, intraoperative condition, best corrected visual acuity(BCVA), intraocular pressure, amplitude of N1 wave latency, central macular thickness(CMT)in the macular area before and after operation, and postoperative complications were compared between the two groups. The influencing factors of vitreous rehaemorrhage in PDR patients were analyzed. <p>RESULTS:The operative time, intraoperative bleeding rate, electrocoagulation rate, incidence of iatrogenic retinal hiatal aperture, the number of laser points and silicone oil filling rate of the observation group were all lower than those of the control group(<i>P</i><0.05). After 6mo, BCVA(LogMAR), CMT and N1 wave latencies amplitude of the two groups were improved compared with those before operation, and the observation group was better than the control group(all <i>P</i><0.05). The incidence of total complications in the observation group was lower than that in the control group(14.8% <i>vs</i> 40.8%, <i>P</i><0.05). There were 31 cases and 31 eyes with vitreous rehaemorrhage after operation. Multivariate Logistic regression analysis showed that elevated HbA1c, vascular occlusion, proliferative retinal traction and no use of conbercept were risk factors for postoperative vitreous rehaemorrhage in PDR patients.<p>CONCLUSION: Conbercept combined with 25G minimally invasive vitrectomy in the treatment of PDR can reduce the intraoperative bleeding rate, reduce complications, shorten the operation time, and thus help to improve visual acuity and visual function. Effective control of blood glucose to reduce HbA1c level, intraoperative removal of fibrovascular hyperplasia membrane as much as possible to relieve retinal traction, and combined treatment with conbercept can reduce the risk of postoperative vitreous rehaemorrhage.
ABSTRACT
@#AIM:To explore clinical characteristics, outcomes and prognostic factors for cases with intraocular foreign bodies(IFB)and treated with 25G minimally invasive vitrectomy(PPV).<p>METHODS: Patients traumatized with retained IFB and treated with PPV were retrospectively collected from the Department of Ophthalmology, Affiliated Hospital of Southwest Medical University from 2016-1-1 to 2019-1-1. The clinical records including general condition, time and cause of injury, locations andsize of IFBs, comorbidities, and best corrected visual acuity(BCVA)were reviewed and statistical analyzed.<p>RESULTS: Among the 105 patients, most of them are middle-aged and young men, mostly from townships. The nature of IFB was mainly metals(62 cases, 59.0%). The entrance of IFB of 78 cases(74.3%)located at Zone I of the eye. There were 17 patients with BCVA≥0.1 before surgery, 88 patients with BCVA<0.1. And 43 patients gained BCVA≥0.1 after operation, and 62 patients with BCVA<0.1. Postoperative BCVA was significantly improved compared with preoperative BCVA(<i>P</i><0.05). Through multivariate Logistic regression analysis, poor preoperative BCVA, retinal detachment, and endophthalmitis are risk factors for poor visual prognosis.<p>CONCLUSION: PPV for treatment of IFB can achieve a better outcome. The poor prognosis of visual acuity is related to retinal detachment, endophthalmitis, and the position and size of IFB.