Evaluation of vitrectomy combined preoperative intravitreal ranibizumab and postoperative intravitreal triamcinolone acetonide for proliferative diabetic retinopathy
Evaluation of vitrectomy combined preoperative intravitreal ranibizumab and postoperative intravitreal triamcinolone acetonide for proliferative diabetic retinopathy
复制标题
玻璃体切除术联合术前玻璃体腔内注射雷珠单抗和术后玻璃体腔内注射曲安奈德治疗增殖性糖尿病视网膜病变的评价
DOI：
10.1007/s10792-021-01703-6
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发表时间：
2021-02-04
影响因子：
1.6
通讯作者：
Zhao, Guiqiu
中科院分区：
文献类型：
--
作者：
Hu, Liting;Chen, Qiulu;Zhao, Guiqiu
目的探讨术前玻璃体内注射雷珠单抗（IVR）联合术后玻璃体内注射曲安奈德（IVTA）治疗增生性糖尿病视网膜病变（PDR）玻璃体切除术（PPV）的疗效。方法回顾性分析128例128眼PDR患者行PPV的临床资料。接受单次PPV的患者被分配至A组。接受PPV和术前IVR的患者被分配到B组。C组患者接受PPV联合术前IVR和术后IVTA。在6个月随访时回顾性评价了术中发现、平均最佳矫正视力（BCVA）变化和术后不良事件。结果B组和C组医源性破裂、术中严重出血、长期使用内填充剂、玻璃体积血（VH）复发率及手术时间均低于A组，差异有统计学意义。术后1个月时，B组和C组的术后BCVA分别在统计学上显著优于A组。C组术后3个月平均视力较好。术后第1周C组高眼压发生率明显高于对照组。三组间渗出性视网膜脱离和脉络膜脱离的发生率差异无统计学意义。结论在PDR患者接受PPV治疗时，术前IVR能显著降低术中术后并发症的发生，术前IVR与术后IVTA联合应用能更好地改善术后视力。
Background To explore the treatment efficacy of the combination of preoperative intravitreal ranibizumab (IVR) and postoperative intravitreal triamcinolone acetonide (IVTA) in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods A retrospective comparative study was performed on 128 eyes of 128 patients who had PDR and underwent PPV. Patients who received a single PPV were assigned to Group A. Those who received PPV with preoperative IVR were assigned to Group B. Patients in Group C underwent PPV combined preoperative IVR and postoperative IVTA. Intraoperative findings, changes in mean best-corrected visual acuity (BCVA) and postoperative adverse events, were retrospectively evaluated at 6-month follow-up. Results The incidences of iatrogenic breaks, severe intraoperative bleeding, using long-term internal tamponade agents, recurrent vitreous hemorrhage (VH), and duration of surgery were statistically significantly less in Group B and Group C than in Group A. The postoperative BCVA was statistically significantly better in Groups B and Group C than in Group A, respectively, at 1 month after surgery. The mean 3-month postoperative visual acuity was better in Group C. The incidence of high intraocular pressure (IOP) was significantly higher in Group C at the first postoperative week. There were no statistically significant differences in the incidence of exudative retinal detachment and choroidal detachment among the three groups. Conclusion In patients undergoing PPV for PDR, preoperative IVR significantly reduced the occurrence of intraoperative and postoperative complications, and the combination of preoperative IVR and postoperative IVTA can better improve the postoperative visual outcome.