目的：评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法：回顾性分析中山眼科中心2016—2019年入院，因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼，术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率，比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA)，通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果：在总的71只眼中，有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升（P＜0.001），黄斑平均光敏度增加（P＜0.000 1）、黄斑完整指数降低（P＜0.000 1）、固视稳定性P1（P＜0.000 1）及P2（P＜0.001）均提升。结论：内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式，空气填充可有效地辅助黄斑裂孔愈合，可作为优先考虑的术中填充物，减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。
Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P < 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.
目的：探讨内镜下泪囊鼻腔吻合(endoscopic dacryocystorhinostomy, En-DCR)联合双管人工泪管植入(bicanalicular silicone tube intubation, BSTI)术治疗小泪囊型慢性泪囊炎的疗效。方法：回顾2020年7月—2023年3月在温州医科大学附属眼视光医院通过CT泪囊造影术(CT dacryocystography, CT-DCG)确诊的单眼小泪囊型慢性泪囊炎并接受手术的患者69例(69眼)，手术采取术中开放泪总管平面的En-DCR并联合BSTI术治疗。术后3个月取出人工泪管，通过术前和术后9个月随访资料，记录和分析了纳入患者的基本资料、手术治疗、治疗效果(包括解剖成功率和功能成功率)和并发症情况。结果：本研究最终纳入61例(61眼)患者，其中男21例、女40例，右眼33眼、左眼28眼。平均年龄为(55.31±12.28)岁(范围为27~75岁)。所有患者均顺利完成术中开放泪总管平面的En-DCR并联合BSTI术治疗。随访9个月，En-DCR的解剖成功率为80.33%(49/61)，功能成功率为75.41%(46/61)，在随访过程中未出现视力下降、眶内出血、感染扩散等并发症。结论：En-DCR联合BSTI术治疗小泪囊型慢性泪囊炎可取得较为满意疗效。
Objective: To evaluate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) Combined with bicanalicular silicone tube intubation (BSTI) for the Management of Chronic dacryocystitis with Small Lacrimal sac. Methods: A total of 69 patients (69 eyes) with chronic dacryocystitis with small lacrimal sac diagnosed by CT dacryocystography (CT-DCG) treated with En-DCR combined with BSTI at the Eye Hospital of Wenzhou Medical University from July 2020 to March 2023 were reviewed. The surgery procedure exposed the plane of common canalicular, and followed by BSTI. The tube was removed 3 months after surgery. The basic data, surgical treatment, therapeutic effect (including anatomical and functional success rates) and complications of the included patients were recorded and analyzed through the follow-up data before and 9 months after surgery. Results: Ultimately, 61 patients (61 eyes) were included in this study—21 males and 40 females—with a distribution of 33 right eyes and 28 left eyes. The mean age was calculated at 55.31±12.28 years (range: 27 to 75 years). All patients underwent a successful En-DCR with exposed the plane of common canalicular and BSTI. At the nine-month follow-up, the anatomical success rate of En-DCR was 80.33%(49/61), the functional success rate was 75.41%(46/61). No complications such as visual impairment, intraorbital hemorrhage, or spread of infection occurred during the follow-up period. Conclusions: The combination of En-DCR and BSTI surgery for chronic dacryocystitis with small lacrimal sac can achieve a satisfactory therapeutic effect.
睑板腺功能障碍(meibomian gland dysfunction, MGD)是一种慢性弥漫性睑板腺疾病，可引起眼红、眼干、异物感等眼部不适，影响患者的眼健康及生活质量。强脉冲光(intense pulsed light, IPL)作为一种新兴有效的物理治疗方法，目前已广泛应用于治疗MGD及其他常见的眼表疾病，如蠕形螨性睑缘炎、睑缘炎相关角结膜病变、复发性睑板腺囊肿等。在IPL临床应用中，规范的操作是保障治疗有效性与安全性的关键。为更好指导和规范临床眼科医护人员的IPL治疗操作，由中山大学中山眼科中心牵头，联合全国19所医疗机构，经过多次修订，于2023年12月17日在全国团体标准信息平台发布了《强脉冲光治疗睑板腺功能障碍操作流程》的团体标准。文章旨在对该团体标准进行深度解读，详细阐述操作中的重点、难点与操作细节，以更好地指导临床工作。
Meibomian gland dysfunction is a chronic diffuse meibomian gland disease that can cause eye discomfort such as redness, dryness, and foreign body sensation in patients, and influence their eye health and quality of life. Intense pulsed light (IPL), as an effective physical therapy for meibomian gland dysfunction, is being used to treat meibomian gland dysfunction and related diseases widely, such as demodex blepharitis, keratoconjunctivitis, recurrent meibomian gland cysts and so on.. In the clinical application of IPL, standardized procedures are key to ensuring the effectiveness and safety of treatment. In order to better guide and standardize the IPL treatment operation of clinical ophthalmic medical workers, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and joined with 19 medical institutions across the country, after multiple revisions, the group standard " Operation Procedure of Intense Pulsed Light for Meibomian Gland Dysfunction" was released on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group's standards, detailing the key points, difficulties, and operational details of specific operations, in order to better guide clinical work.
目的：对比玻璃体切割术(pars plana vitrectomy, PPV)联合或不联合注射地塞米松玻璃体内植入剂(dexamethasone intraveal implant, DEX)治疗特发性黄斑前膜(idiopathic macular epiretinal membrane, IMEM)的临床疗效。
方法： 采用回顾性研究设计，收集2022年1月—2023年6月于惠州市中心人民医院就诊，被诊断为IMEM(Gass 2期)并行PPV联合phaco+IOL植入的患者49例(49只眼)。根据其治疗方案分为非联合注射DEX组(25例共25只眼)及联合注射DEX组(24例共24只眼)。记录所有患者术前术后的最佳矫正视力(best corrected visual acuity, BCVA)、黄斑中心凹视网膜厚度(central macular thickness, CMT)、平均神经节细胞层(ganglion cell layer, GCL)厚度，椭圆体带(ellipsoidal zone, EZ)完整性。使用OCTA测量视网膜浅层毛细血管层(superficial capillary plexus, SCP)、中心区域血管密度(vessel densities, VDs)及中心凹无血管区(foveal avascular zone, FAZ)面积。使用非接触性眼压计测量患者眼压。随访至术后6个月，记录上述指标，其中BCVA及CMT随访至1年。使用SPSS 29.0软件进行数据的统计分析(独立样本t检验、Mann-Whitney U检验、Pearson χ2检验等)。使用重复测量方差检验分析各项指标的时间差异及交互差异性。采用线性回归分析CMT、平均GCL厚度、EZ完整性、VDs、FAZ面积及联合注射DEX与BCVA的相关性。
结果：本研究两组间性别、年龄、眼压及术前各项指标差异均无统计学意义(P>0.05)。两种术式均能改善黄斑区结构、功能及微循环障碍，术后的BCVA在两组患者中均较术前有所改善，且持续至术后6个月，CMT的变化趋势同BCVA有高度一致性，而平均GCL厚度于术后3个月时开始恢复，而SCP中心凹VDs及FAZ面积于术后6个月时才有明显恢复，两种术式术后以上各指标均具有时间差异及交互差异性(P≤0.015)，且6个月内联合注射DEX组表现更佳(P=0.036)。相较于非联合注射DEX组，只有联合注射DEX组在术后6个月时，EZ完整性的改善具有统计学意义(P=0.009)。但随访至1年时，两组之间BCVA及CMT差异均无统计学意义(P=0.079)。术后6个月内BCVA的改善与术后6个月的CMT、平均GCL厚度、SCP中心凹VDs、FAZ面积的改善及EZ完整性及是否注射DEX与术后6个月内BCVA的改善均有相关性。随访期间两组患者均未发生眼内炎、玻璃体积血、视网膜脱离等眼部或全身严重并发症。
结论：微创玻璃体切割术联合玻璃体内注射DEX治疗相较于非联合注射DEX治疗组在6个月内疗效更佳。联合单次注射DEX治疗方案与非联合注射DEX治疗方案相比，在手术1年后对BCVA及CMT的改善无明显差异。
Objective: To analyze the efficacy and safety of minimally invasive vitrectomy (PPV) with or without intraoperative injection of dexamethasone intravitreal implant (DEX) for the treatment of Idiopathic Macular Epiretinal Membrane (IMEM), by comparing the relevant indicators.Methods: A retrospective study design was used to collect 49 patients (49 eyes) who were diagnosed with IMEM (Gass2) and underwent surgical treatment(PPV+phaco+IOL implantation) at Huizhou Central People’s Hospital from January 2022 to June 2023. According to their treatment plan, they were divided into a non-combined injection DEX group (25 cases, 25 eyes) and a combined injection DEX group (24 cases,24 eyes). All patients underwent comprehensive optometry before and after surgery, and their best corrected visual acuity (BCVA) was recorded. Scan the central macular thickness (CMT) within 6x6mm of the macular area, while scanning the average ganglion cell layer (GCL) thickness. Record whether the elliptical zone (EZ) within 1x1mm of the macular area is complete and continuous. Use OCTA mode to scan the superficial capillary layer (SCP) of the retina within a range of 6x6mm, and record the measurements of vascular density (VDs) in the central area and the area of the foveal avascular zone (FAZ). Measure the patient's intraocular pressure using a non-contact tonometer. Follow up for 6 months and record the above indicators, with BCVA and CMT followed up for 1 year. Perform statistical analysis of data using SPSS 29.0 software (Independent sample t-test, Mann Whitney U-test and Pearson χ2-test). Use repeated measures ANOVA to analyze the time differences and interaction differences of various indicators. Linear regression analysis was used to examine the correlation between CMT, mean GCL thickness, EZ integrity, VDs, FAZ area, and combined injection of DEX with BCVA.Results: There were no statistically significant differences in gender, age, intraocular pressure, and preoperative indicators between the two groups (P>0.05). Both surgical methods can improve the structure, function, and microcirculation disorders in the macular area. The postoperative BCVA in both groups of patients improved compared to before, and persisted until 6 months after surgery. The trend of CMT changes was highly consistent with BCVA, while the average GCL thickness began to recover at 3 months after surgery. The SCP fovea VDs and FAZ area did not show significant recovery until 6 months after surgery. Both surgical methods showed time differences and interaction differences in the above indicators after surgery (P=0.015), and the combined injection of DEX group performed better within 6 months (P=0.036). Compared to the non combined injection of DEX group, only the combined injection of DEX group showed statistically significant improvement in EZ integrity at 6 months after surgery (P=0.009). However, at 1 year of follow-up, there was no statistically significant difference in BCVA and CMT between the two groups (P≥0.079). The improvement of BCVA within 6 months after surgery is correlated with the improvement of CMT, average GCL thickness, SCP fovea VDs, FAZ area, EZ integrity, and injection of DEX within 6 months after surgery. During this study, no serious ocular or systemic complications such as endophthalmitis, vitreous hemorrhage, or retinal detachment occurred in either group of patients at each follow-up time point.
Conclusions: The efficacy of PPV combined with intravitreal injection of DEX is better within 6 months compared to the non-combined injection of DEX treatment group. There was no significant difference in the improvement of BCVA and CMT after one year of surgery between the combined single injection DEX treatment regimen and the non-combined injection DEX treatment regimen.
目的：研究经鼻内镜低位泪囊鼻腔吻合术联合RT新型人工泪管置入手术的临床有效性和安全性。方法：采用前瞻性随机对照研究，将临床诊断为原发性鼻泪管阻塞继发的慢性泪囊炎患者随机分为两组。研究组(A组)43例(44眼)采用低位经鼻内镜泪囊鼻腔吻合联合新型RT人工泪管置入术。对照组(B组)39例(39眼)采用常规经鼻内镜泪囊鼻腔吻合联合双泪小管置入式人工泪管置入。术后3～6个月取出人工泪管，随访时间1～12个月，平均6个月。观察术中术后的并发症，评估其安全性。结果： A组治愈42眼(95.45%)，好转2眼(4.54%)；B组治愈38眼(97.43%)，好转1眼(2.56%)，两组比较差异无统计学意义(P＞0.05)。B组有12眼(30.77%)使用骨动力系统用于磨削骨质，A组未使用骨动力系统；A组手术时间为(31.88±1.64) min；B组手术时间为(48.54±4.40) min，两组比较差异有统计学意义(P <0.01)；B组术后人工泪管从内眦脱出2例，A组在人工泪管置入或取出时，均无管体被拉断裂的病例，无人工泪管从内眦侧脱出的病例。两组患者术后均无人工泪管导致的泪点撕裂，术后随访平均6个月，均无复发。结论：低位经鼻内镜泪囊鼻腔吻合术联合RT新型人工泪管置入可以作为一种新的治疗慢性泪囊炎手术有效、安全的方法。
Objective: To study the efficacy and safety of endonasal endoscopic lower position dacryocystorhinostomy(En-LPDCR) combined with new RT lacrimal stent intubation for treating chronic dacryocystitis. Methods: In A prospective randomized controlled study, patients with chronic dacryocystitis secondary to primary nasolacrimal duct obstruction who met the inclusion criteria were randomly divided into two groups. In study group (Group A), 43 cases (44 eyes) were treated with the En-LP-DCR combined with new RT lacrimal stent intubation. Control group (Group B), 39 cases (39 eyes): conventional endoscopic dacryocystorhinostomy combined with bicanalicular intubation. The stent was removed from 3 to 6 months after surgery and followed up 6 to 12 months. Results: There was no recurrence of chronic dacryocystitis in both groups. In group A, 42 eyes (95.45%) were cured and 2 eyes (4.54%) were improved. In group B, 38 eyes were cured (97.43%) and 1 eye was improved (2.56%), there was no significant difference between the two groups (P > 0.05). In group B, 12 eyes (30.77%) With the incorporation of powered instrumentation to make bony ostium with full exposure of the lacrimal sac., while group A did not use powered dynamic system. Operation time of group A was (31.88±1.64) min; The operation time of group B was (48.54±4.40) min. The difference between the two groups was significant (P < 0.01). In group B, the stent dislocated from the medial canthus in 2 cases, while in group A, there were no cases of the stent dislocated. No patient with dislocation, displacement of stent and punctum erosion founded in both groups, and no recurrence of chronic dacryocystitis was observed during the average follow-up of 6 months. Conclusion: Endonasal endoscopic lower position dacryocystorhinostomy combined with new RT lacrimal stent intubation is a new and effective method for the treatment of chronic dacryocystitis, with minimally surgical injury and faster postoperative recovery.
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。
目的：探讨胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果。方法：2003年12月－2008年12月在我院就诊的原发性翼状胬肉患者55例57眼，均采用胬肉切除联合自体角膜缘干细胞移植治疗，术后随访2～8年，平均5.3年。观察创面愈合情况、治疗效果和并发症情况。结果：术后早期患者均有不同程度的充血、水肿和异物感，3～5d 后症状逐渐减轻，一周左右完全消失。角膜创面完全上皮化时间为4～7d，平均4.83d。术后有持续性眼表刺激症状者7例，术后残留纤维组织者1例，角膜浅层瘢痕者4例。术后随访2～8年，平均5.3年，复发8例8眼 (复发率13.11％)。术后1年时复查OSDI 评分，所有患者较术前评分均有不同程度的降低，与术前相比，两组评分和构成比差异有统计学意义(P＜0.05)。术后5年时复查OSDI评分较1年前稍有降低，但差异没有统计学意义(P＞0.05)。术后1、5年时泪液基础分泌[(12.95±4.03) mm，(12.68±4.77) mm]和泪膜破裂时间 [(10.55±4.13)s, (10.03±4.64) s] 较术前[(9.48±3.34)mm，(8.14±3.57)s] 明显改善，差异有统计学意义(P＜0.05)。结论：应用胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉，术后早期症状轻、消失快，远期复发少，效果良好。
Purpose: To evaluate the long-term efficacy of pterygium excision combined with autologous corneal limbal stem cell transplantation in the treatment of pterygium．Methods: Fifty five patients (57 eyes) diagnosed with primary pterygium undergoing pterygium excision combined with autologous corneal limbal stem cell transplantation between December 2003 and December 2008 were enrolled in this study. Postoperative follow-up endured for 2-8 years, 5.3 years on average. The wound healing, clinical efficacy and postoperative complications were observed．Results: During early stage after surgery, all patients presented with varying degree of hyperemia, edema and sense of foreign body, which were gradually mitigated 3-5 d later and completely recovered in approximately 1 week. The corneal wound was completely epithelized within 4-7 d, 4.83 d on average. Seven patients had persistent ocular surface irritation symptoms after surgery, one case had residual fibrous tissues and four patients developed superficial corneal scars. Postoperative follow-up endured for 2-8 years, 5.3 years on average. Eight patients (8 eyes) recurred with a recurrence rate of 13.11％. In all patients, postoperative OSDI score was significantly decreased at 1-year reexamination. OSDI score and constitution ratio significantly differed between two groups (both P＜0.05)．At postoperative 5 years, OSDI score was slightly lower compared with that in last year with no statistical significance(P＞0.05)．At post operative 1- and 5-year, basic tear secretion was (12.95 ±4.03) mm and (12.68 ±4.77) mm, tear film break-up time was (10.55±4.13)s and (10.03±4.64)s. Both indexes were significantly improved compared with (9.48±3.34) mm and (8.14±3.57)s before surgery (all P＜0.05)．Conclusion: Pterygium excision combined with autologous corneal limbal stem cell transplantation is an efficacious treatment of pterygium with mild postoperative symptoms, rapid recovery, low long-term recurrence rate and high efficacy．
目的：评估Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症。方法：收集汕头国际眼科中心2011至2016年门诊确诊的水液缺乏型干眼患者300例(600眼)，进行Smart plug泪小管塞治疗，随访观察术后临床并发症，中位随访时间为术后3年(术后1~5年)。结果：3例患者(3眼)术后患有泪小管炎(0.5%)，发病时间为术后1~3(中位2)年，取出泪小管塞后并给予局部抗生素滴眼液治愈。2例患者 (4眼)因植入上下泪小管塞后流泪症状不能耐受，单纯取出下泪小管塞后症状缓解(0.7%)；4例患者(8眼)因只植入下泪小管塞症状未能明显好转，1个月后再次植入上泪小管塞(1.3%)；291例患者干眼主观症状改善，有效率为97.5%，长期随访未发现并发症。结论：虽然Smart plug泪小管塞治疗水液 缺乏型干眼具有明确的疗效，但Smart plug泪小管塞植入后的长期并发症不容忽视，需要长期观察。
Objective: To evaluate the long-term complication associated with the use of the Smart plug in the treatment of aqueous tear deficiency dry eye. Methods: A total of 300 patients (600 eyes) were collected in Joint Shantou International Eye Center from 2011 to 2016, all the patients accepted the treatment with Smart plug, and were followed up for clinical complications. The median follow-up time was postoperative 3 years (1–5 years after surgery). Results: Three patients (3 eyes) developed canaliculitis, the rate was 0.5%. The median time from Smart plug insertion to the onset of canaliculitis was 2 (1–3) years, leaving the Smart plug and resolved the application of topical antibiotics. Two patients (4 eyes) could not suffer from implantation of the upper and lower Smart plug, removed the below, the ratio was 0.7%; 4 patients (8 eyes) need upper Smart plug insertion after implantation of the lower one month later, the rate was 1.3%; 291 cases of dry eye improved by long-term followup, the effective rate was 97.5%. Conclusion: Although the Smart plug is effective in the treatment of aqueous tear deffciency dry eye, the later complications of Smart plug insertion cannot be neglected and need the long-term follow-up.
青光眼是全球第二大致盲眼病，第一大不可逆性致盲眼病，其中原发性闭角型青光眼（primary angle closure glaucoma，PACG）占 25%。激光周边虹膜切除术（laser peripheral iridotomy，LPI）已成为 PACG 和原发性房角关闭的一线治疗。LPI 机制为利用激光在周边虹膜上打孔，解除 PACG 的瞳孔阻滞，加深前房，扩大房角，恢复生理性房水排出途径，从而降低眼压。研究表明 LPI 在原发性房角关闭各个疾病进程中均能比较好的控制眼压，是相对安全的治疗方法。
Glaucoma is the second leading cause of blindness and the most common cause of irreversible blindness worldwide. Primary angle closure glaucoma (PACG) accounts for 25% of glaucoma. Laser peripheral iridotomy (LPI) has become the first line treatment for PACG and primary angle closure (PAC). The mechanism of LPI is to use laser to create a hole in peripheral iris to relieve pupil block, deepen anterior chamber, expand chamber angle, restore pathway of physiological aqueous discharge and reduce intraocular pressure. Studies have shown that LPI can control intraocular pressure well in all stages of PAC, which is safe for PAC.
目的：探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法：选取96例患者，共175只眼，随机分为对照组(48例，86只眼)和研究组(48例，89只眼)。两组均予全视网膜激光光凝治疗，其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后，观察两组患者治疗前后视力、血液流变学的变化。结果：治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779，P=0.009)， 而2组在视力≤0.4，0.4~0.6，0.7~1.0范围患者视力差异比较分别为( χ2=0.003，P=0.955)，(χ2=1.640，P=0.200)，(χ2=2.148，P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%，对照组75.6%，两组差异比较(χ2 =6.302，P=0.012)。结论：全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病，能有效提高视力及临床疗效，可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.
