目的:我们试图验证术中光学相干断层扫描(iOCT)对玻璃体切除术治疗增生性糖尿病视网膜病变(PDR)的效果。
方法:回顾性研究。
方法:我们回顾了2013年4月至2017年12月期间由一名外科医生进行25号玻璃体切除术治疗的178只PDR眼。总的来说,77例PDR患者98只眼(平均年龄,52.5±11.7年),使用iOCT(iOCT组)进行玻璃体切除术,60例PDR患者的80只眼(平均年龄,53.1±10.9年)无iOCT(非iOCT组)治疗纳入研究。为了确定玻璃体切除术与iOCT相结合的效果,对接受该联合治疗的患者和接受不使用iOCT的玻璃体切除术的患者进行了比较.根据术中并发症评估这些治疗方法的效果,再手术率,术后并发症,操作次数,和术后视力。
结果:与非iOCT组(91.3±31.2min)相比,iOCT组的手术时间(72.9±23.9min)明显缩短(P=0.001)。术中并发症的发生率,再操作,术后并发症在两组间无显著差异(P分别为.542,0.258和0.860).手术后六个月,两组术后视力无显著差异(P=.508).多元线性回归分析显示手术时间与iOCT显著相关(β[标准部分回归系数]=-0.28,P<.001),纤维血管增殖膜(β=0.17,P=0.009),白内障手术(β=0.22,P=.016),术前视网膜光凝(β=-0.14,P=.021),术中并发症(β=0.16,P=0.023),和玻璃体后脱离(β=-0.14,P=.04)。
结论:使用iOCT减少了手术时间,而不影响术中和术后并发症的发生率,再手术率,或接受PDR玻璃体手术的患者的术后视力。
OBJECTIVE: We sought to verify the effect of intraoperative optical coherence tomography (iOCT) on vitrectomy for the treatment of proliferative diabetic retinopathy (PDR).
METHODS: Retrospective study.
METHODS: We reviewed 178 eyes with PDR treated with 25-gauge vitrectomy by a single surgeon between April 2013 and December 2017. In total, 98 eyes of 77 patients with PDR (mean age, 52.5 ± 11.7 years) treated with vitrectomy using iOCT (iOCT group) and 80 eyes of 60 patients with PDR (mean age, 53.1 ± 10.9 years) treated without iOCT (non-iOCT group) were included in the study. To determine the effects of combining vitrectomy with iOCT, a comparison was made of patients treated with this combination and patients treated with vitrectomy without iOCT. The effects of these treatments were assessed on the basis of intraoperative complications, reoperation ratios, postoperative complications, operation times, and postoperative visual acuity.
RESULTS: The operation time was significantly reduced for the iOCT group (72.9 ± 23.9 min) when compared with the non-iOCT group (91.3 ± 31.2 min) (P = .001). The incidences of intraoperative complications, reoperation, and postoperative complications did not differ significantly between the 2 groups (P = .542, 0.258, and 0.860 respectively). Six months after surgery, the postoperative visual acuity did not differ significantly between the 2 groups (P = .508). Multiple linear regression analysis revealed that the operation time was significantly correlated with iOCT (beta [standard partial regression coefficient] = - 0.28, P < .001), the fibrovascular proliferative membrane (beta = 0.17, P = .009), cataract surgery (beta = 0.22, P = .016), preoperative retinal photocoagulation (beta = - 0.14, P = .021), intraoperative complications (beta = 0.16, P = .023), and posterior vitreous detachment (beta = - 0.14, P = .04).
CONCLUSIONS: Use of iOCT reduced the operation time without affecting the incidence rates of intraoperative and postoperative complications, reoperation ratios, or postoperative visual acuities in patients who underwent vitreous surgery for PDR.