Effect and complications of different combined surgeries for proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#AIM: To evaluate the efficacy and postoperative complications of different combined surgeries in the treatment of proliferative diabetic retinopathy(PDR). <p>METHODS: The clinical data of 72 patients(82 eyes)with PDR were retrospectively analyzed. According to the different combined methods, the patients were divided into three groups Group A(28 eyes)underwent vitrectomy combined with phacoemulsification and intraocular lens(IOL)implantation; Group B(24 eyes)underwent vitrectomy combined with intravitreal injection of conbercept, phacoemulsification and IOL implantation; and Group C(30 eyes)underwent vitrectomy in the first phase, and then underwent silicone oil removed combined with phacoemulsification and IOL implantation in the second phase. Visual acuity and postoperative complications were observed. <p>RESULTS: The follow-up period was 6-12mo. The mean postoperative LogMAR BCVA of Group A(1.007±0.455), Group B(1.000±0.482)and Group C(1.033±0.531)had all improved than their preoperative BCVA respectively, the difference was statistically significant(<i>t</i>=5.666, 5.113, 5.496; <i>P</i><0.05). There was no statistical difference compared postoperative BCVA among three groups(<i>F</i>=1.670, <i>P</i>=0.195). The main postoperative complications were anterior chamber fibrin exudation(Group A 6 eyes, Group B 0 and Group C 1 eyes), temporary intraocular hypertension(Group A 5 eyes; Group B 4 eyes and Group C 10 eyes), macular edema(Group A 1 eyes, Group B 0 and Group C 0), neovascular glaucoma(Group A 2 eyes, Group B 0 and Group C 0)and rebleeding(Group A 2 eyes, Group B 1 eyes and Group C 3 eyes). There were statistical difference compared anterior chamber fibrin exudation among three groups(<i>χ</i>²=7.556,<i>P</i>=0.008). The incidence of anterior chamber fibrin exudation in Group A was significantly higher than that in Group B(<i>χ</i>²=5.814,<i>P</i>=0.016), without significant difference compared with Group C(<i>χ</i>²=4.469,<i>P</i>=0.035). There was no statistical difference compared other postoperative complications among three groups(<i>P</i>>0.05). <p>CONCLUSION: Each group could help earlier visual rehabilitation and avoid second operation for post-vitrectomy cataract. Compared with the Group C, Group A or Group B is much clearer to observe the ocular fundus and easier to operate. Anterior chamber fibrin is heavier in Group A, intravitreal injection of conbercept can reduce anterior chamber fibrin exudation in combined surgical method.