目的:对增生型糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体联合晶状体切除术后发生新生血管性青光眼(neovascular glaucoma,NVG)的原因和治疗进行临床研究。方法:PDR患者行玻璃体切除联合晶状体超声乳化人工晶状体植入术,对术后发生NVG的患者7例7眼的原因进行临床分析,并对其进行补充光凝联合Ahmed阀门植入术治疗,术后观察视力及眼压的变化。结果:术后3~6mo时间段内NVG发生率最高(71.4%),手术后7眼均未再行眼底荧光血管造影检查和视网膜光凝。发生NVG后给予补充激光光凝联合Ahmed阀门植入术,眼压控制的总有效率为71.4%,术后无视力下降者,新生血管全部或部分消退。结论:患者的病变程度和血糖的稳定性、术中的手术技巧和充分光凝、术后定期随访和及时补充光凝等对术后发生NVG均有一定的影响;及时补充光凝联合Ahmed阀门植入术可控制眼压、使新生血管消退,是治疗NVG的一种安全而有效的方法。

AIM:To study the factors and treatments of neovascular glaucoma(NVG)after vitrectomy and lens removal for proliferative diabetic retinopathy(PDR)patients.METHODS:The postoperative NVG was analyzed in 7 PDR patients(7 eyes)after vitrectomy and phacoemulsification.Then they underwent the implantation of glaucoma valve combined with retinal photocoagulation.The visual acuity and intraocular pressure(IOP)were observed.RESULTS:NVG that occurred in 3-6 months after operation was the most(71.4%),all eyes had not been treated by further panretinal photocoagulation(PRP)and fundus fluorescein angiography(FFA)before occurring NVG.After treatment,the IOP was controlled in 5 eyes(71.4%),without declining eyesight,the new vessels decreased or regressed.CONCLUSION:The factors like the degree of disease,the stability of blood glucose,the skill and PRP in operation,the postoperative follow-up and further PRP,etc,all can influence the occurrence of NVG.Glaucoma valve combined with PRP can not only decrease IOP but also decrease or regress the new vessels.It is a safe and effective approach to those NVG patients.

R779.6