白内障摘除人工晶体植入术后的糖尿病视网膜病变激光治疗疗效分析

目的：观察白内障人工晶体植入术后糖尿病视网膜病变（DR）的氩激光光凝治疗后的近、远期效果和光凝治疗的时机及影响光凝的因素。方法：采用Zeiss Visulas氩离子眼科激光治疗仪对36例58只眼的光凝术方法及治疗效果进行回顾性分析。结果：42只眼行广泛视网膜光凝术,16只眼行局部视网膜光凝术,其中6只眼伴有人工晶状体后囊混浊,先期行Nd：YAG激光切开后囊膜。24只眼视力提高1～2行,占41.4%,其中BDR16眼,PPDR8眼;28只眼视力无变化,占48.3%,其中PPDR24眼,PDR4眼;6只眼视力下降,占10.3%,均为PDR。3个月后行荧光素眼底血管造影（FFA）检查,新生血管大部萎缩,视网膜水肿消退。结论：适时的白内障摘除联合IOL置入,合理及时的激光治疗,是控制糖尿病患者眼底病变继续恶化的重要手段。FFA是进行正确有效激光治疗的重要参考依据,而放置大直径IOL又是完善眼底激光治疗的先决条件。

Laser treatment of diabetic retinopathy after cataract extraction combined with intraocular lens implantation

Objective:To investigate the effect of laser photocoagulation treatment on diabetic retinopathy after cataract extraction combined with intraocular lens implantation and discuss the factors which affected the success rate of treatment and the opportunity of laser photocoagulation treatment.Methods:58 diabetic retinopathy eyes(36 cases) were treated with Zeiss Visulas ophthalmic laser. The method of photocoagulation and result were analyzed retrospectively. Results:42 eyes underwent panretinal photocoagulation,16 eyes underwent local photocoagulation.Nd:YAG laser posterior capsulotomy in 6 eyes accompanied with posterior capsular opacity was performed before retina photocoagulation. Visual acuity improved in 24 eyes,remained stable in 36 eyes, decreased in 14 eyes. 3 months later,Fundus fluorescein angiography(FFA) showed neovascularity atrophied and retina edema subsided.Conclusion:Timely cataract extraction combined with intraocular lens implantation,rational and timely laser therapy are important methods to control diabetic retinopathy. FFA is an important reference to perform laser photocoagulation. Placing big size IOL is a preliminary requirement to perform laser photocoagulation perfectly.