糖尿病視網膜病變玻璃體切除術后新生血管性青光眼原因分析

秦桂娟 劉兵

[摘要] 目的 深入分析糖尿病視網膜病變患者在玻璃體切除術后出現新生血管性青光眼的原因。方法 該研究擇取2017年1月—2019年12月期間于該院收治的增殖性糖尿病視網膜病變實施玻璃體切除術的患者465例作為研究對象，對實施玻璃體切除術后出現新生血管性青光眼的患者進行分析，并實施針對性的治療，針對預后效果及臨床資料，探究出現新生血管性青光眼的原因。結果 出現新生血管性青光眼的36例患者中，實施晶狀體手術的有27例，出現了后囊破裂或不完整的有16例，術前出現了虹膜新生血管的有8例，術后出現視網膜脫離的有4例。在術后到發生新生血管性青光眼期間，患者都沒有進行眼底熒光血管造影和視網膜光凝檢查。結論 基于研究表明，患者在術后出現新生血管性青光眼的原因，主要是與術中聯合實施晶狀體手術、玻璃體填充物效果和術后發生視網膜脫落等關，在糖尿病視網膜病變玻璃體切除術前及術后需要加強對青光眼的預防，及時針對患者實施眼底熒光血管造影和視網膜光凝等確定手術后患者的實際情況，做好預防措施。

[關鍵詞] 糖尿病;視網膜病變;玻璃體切除術;青光眼

[中圖分類號] R4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）10（a）-0012-03

[Abstract] Objective To deeply analyze the causes of neovascular glaucoma in patients with diabetic retinopathy after vitrectomy. Methods This study selected 465 patients with proliferative diabetic retinopathy who underwent vitrectomy in the hospital from January 2017 to December 2019 as the research object. Analyze patients with neovascular glaucoma after vitrectomy， implement targeted treatment， and explore the causes of neovascular glaucoma based on the prognostic effect and clinical data. Results Among the 36 patients with neovascular glaucoma， 27 cases had lens surgery， 16 cases had posterior capsule rupture or incompleteness， 8 cases had preoperative iris neovascularization， and postoperative retinal detachment in 4 cases. From the postoperative period to the occurrence of neovascular glaucoma， the patient did not undergo fundus fluorescein angiography and retinal photocoagulation. Conclusion Based on research， the reasons for patients with neovascular glaucoma after surgery are mainly related to the joint operation of lens surgery， the effect of vitreous fillers and the occurrence of postoperative retinal detachment. Before and after vitrectomy for diabetic retinopathy， it is necessary to strengthen the prevention of glaucoma after the operation， and timely implement fundus fluorescein angiography and retinal photocoagulation to determine the actual situation of the patient after the operation to take preventive measures.

[Key words] Diabetes; Retinopathy; Vitrectomy; Glaucoma

玻璃體切除術作為現如今治療糖尿病視網膜病變的主要方法之一，由于糖尿病視網膜病變的病情比較復雜，手術實施的難度較大，術中術后經常會發現一些嚴重的并發癥。為了提高糖尿病視網膜病變的治療效果，正在加強對各種并發癥的預防及防治，明確新生血管性青光眼的發生原因以及制定有效的處理措施，是顯著降低并發癥的發生率，確保患者術后視力能有效恢復的有效途徑。……