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Curative effect of peeling of the internal limiting membrane on diabetic macular edema
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1005-1015.2005.03.002
- Key Word:
- 糖尿病视网膜病变/治疗;黄斑水肿,囊样/治疗;吲哚青绿/诊断应用
Abstract： 目的评价视网膜内界膜(ILM)剥离对糖尿病黄斑水肿患者手术后视力恢复的影响.探讨吲哚青绿(ICG)在ILM剥离术中的作用.方法对30例(31只眼)增生期糖尿病视网膜病变伴黄斑水肿患者行玻璃体切割治疗.患者随机分成两组,A组:单纯玻璃体切割16只眼,手术中行全视网膜光凝及20%SF6眼内填充;B组:玻璃体切割加吲哚青绿(ICG)染色ILM剥离15只眼,在A组术式基础上手术中增加ICG染色后极部ILM,并行ILM剥离.所有患者手术后保持面朝下体位10～14 d.患者定期随访3～12个月. 结果A组16只眼中,视力提高2行或2行以上10只眼(62.5%),黄斑水肿消退9只眼(56.2%),手术后光相干断层扫描检查黄斑厚度平均393 μm.B组15只眼中视力提高2行或2行以上14只眼(93.3%),黄斑水肿消退14只眼(93.3%),黄斑厚度平均319 μm.B组手术后视力提高明显优于A组(x2=4.210,P=0.05 Fisher确切检验法);B组患者手术后黄斑区视网膜厚度明显低于A组(P＜0.01独立秩和检验).手术标本证实为ILM.结论玻璃体切割术是治疗糖尿病黄斑水肿的有效方法,ILM剥离能明显提高手术的疗效;ICG能较好地染色ILM,使ILM的剥离更加安全确切.
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