Analysis Of Therapeutic Effect Of Vitrectomy In Treatment Of Diabetic Retinopathy

With the improvement of living standards, the incidence of diabetes has increased annually, More diabetic retinopathy (DR) patients are inclined to demand good eyesight. Now laser photocoagulation and vitrectomy are the effective means to treat diabetic retinopathy (DR).Objective:To investigate the therapeutic effect of vitrectomy in treatment of diabetic retinopathy.Method: 60 proliferative diabetic retinopathy (PDR) patients (62 eyes) who consistent with the operational indication are treated with vitrectomy ,couching,artificial lens implantation,membrane peeling,laser photocoagulation,eligible temponade according to the patients'condition.Results: All of the cases were performed vitrectomy successfully and followed up 3-10 months.The final visual acuity got improved in 52 eyes(83.9 %).Not improved in 6 eyes(9.7%).Visual extinction in 4 eyes(6.4%).20 eyes which crystalline lens were obviously turbid and 5 eyes which crystalline lens turbidity were increasing,were treated with couching. 20 eyes which had thin new-vascular membrane were removaled of new-vascular membrane in conjunction with posterior vitreous cortex, obviously hemorrhage did not happen in surgery. 25 eyes had moderately dense new-vascular membrane ,to tear it with retinal-tweezers or resect it with cutting head, two eyes'blood vessels in the retina occurred errhysis when dyestripping.1 eye'new vessels bleed obviously when cutting.17 eyes'hyperplasia membranes were dense ,which can be broken with vitreous shear,which can be removed with retinal forceps, and some of which had close adhesion with the retina can not be forcibly teared. According to intraoperative findings, identified as diabetic retinopathyⅣ,Ⅴ,Ⅵperiod has separately 14,30 and 18 eyes.In 32 eyes retinal edema, reductus or displacement of limitations retinal traction were finded . In 17 eyes tears retinal were founded. 36 eyes had different degrees of macular edema, one of 15 eyes had yellowish-white macular punctate exudation. 10 eyes had a different range of vascular white lines, and 8 eyes had extensive vascular occlusion of the white lines. Each eye retinal photocoagulation points was the 320-1130 (average 852±118) points.The operational complication included vitreous hemorrhage,corneal bede- wing,iatrogenic tears retinal,retinal separation,rubeosis iridis,neovascular glau- coma,complicated cataract and so on .Conclution:1.Vitrectomy and laser photocoagulation are the main means to treat the proliferative diabetic retinopathy (PDR) patients now,which can improve the visual acuity and the quality of life effectively.To grasp the vitrectomy indication of the proliferative diabetic retinopathy (PDR) patients correctly,the opportunity of vitrectomy and the operational skills,and to deal with the operation and postoperative complications can cut down the occoecatio rate of diabetic ophthalmocace.2.PDR timing of surgery depends on the treatment of the grasp of the continuous improvement of surgical techniques and postoperative follow-up and so tight.3. Apart from the emergence of post-operative complications and surgical techniques, but also with the course of disease and treatment is closely related to the timing.4. Actively deal with intraoperative and postoperative complications, to maximize visual function in patients. 5.DR must to do follow-up of patients in order to observe the condition change at any time, PPDR period of laser photocoagulation are the best period, diabetic retinopathy should be early diagnosis, rational and timely photocoag- ulation treatment, to avoid the progress of the proliferative phase.