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Surgical management for proliferative diabetic retinopathy with diffuse retinal edema and massive subretinal hard exudates         
Surgical management for proliferative diabetic retinopathy with diffuse retinal edema and massive subretinal hard exudates
作者:Wang Zhi… 文章来源:Department of Ophthalmology The General Hospital of Chinese PLA N0. 28 Fuxing Road , Beijing 100853, P.R. China 点击数:8243 更新时间:2006/7/11 23:08:49
Objective To observe the clinical therapeutic effects of surgical treatment for proliferative diabetic retinopathy (PDR) with diffuse retinal edema and massive subretinal hard exudates by vitrectomy, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade. Methods Twenty eyes of seventeen patients with PDR complicated with diffuse retinal edema and massive subretinal hard exudates were selected from October 2001 to December 2005. 12 eyes were in 10 male and 8 eyes were in 7 female. The patients were aged from 34~67 years (mean 54.4). The best corrected visual acuity (BCVA), color founds photograph, founds fluorescein angiography (FFA) were recorded, and optic coherence tomography (OCT) was performed in 12 eyes preoperatively. Pars plana vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade were the methods used to treat the selected eyes. Results Preoperative best corrected visual acuity (BCVA) was finger counting~0.01 in 7 eyes, 0.02~0.05 in 13eyes. All eyes had improved vision during an average follow up period of 14.6 months, 0.03~0.04 was in 3 eyes(15%), BCVA was ≥0.09 in 17 eyes (85%). FFA showed that the extensive fluorescein leakage and macular edema disappeared. Macular thickness decreased from ≥600μm preoperatively to ≤300μm postoperatively. Complete absorption of hard exudates was observed in 18 eyes. Postoperative complications were cataract in 4 eyes and sub-macular scar in 2 eyes. Conclusion Vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade may offer satisfied effects in the treatment for PER with diffuse retinal edema and massive subretinal hard exudates.
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